Pathological Conditions, Signs and Symptoms Commons^™

A Peculiar Presentation Of Cardiac Sarcoidosis As Third-Degree Atrioventricular Heart Block Complicated By Right Ventricle Perforation, Yash Suthar, Pooja Patel, Nikhita Kothari, Kristofer Hillegas

Rowan-Virtua Research Day

• Cardiac sarcoidosis is a rare, inflammatory multisystem disorder that manifests as noncaseating granulomas of multiple organs.

• The clinical presentation of sarcoidosis is variable and may be underrecognized by clinicians.

• Individuals may be asymptomatic during their lifetimes and may be incidentally diagnosed with the disease for the first-time during autopsy.

• Patients with cardiac involvement of sarcoidosis may initially present with complications including arrhythmias, heart block, bundle branch block, congestive heart failure, pericardial effusion, pulmonary hypertension, and/or sudden cardiac death.

An Unusual Ed Case: Scrotal Edema From A Thoracic Aortic Aneurysm In A 58-Year-Old Male, Yevgeniy Polunin, Emily Nguyen, Bhumi Shah

Rowan-Virtua Research Day

Scrotal edema is not an uncommon presentation in emergency medicine. We describe the case of a 58-year-old male with no prior medical history who presented to the emergency department (ED) due to progressive scrotal edema. The patient noted increased painless testicular enlargement, dry cough, and dyspnea on exertion over the course of several weeks. Scrotal edema was evaluated by an Ultrasound (US), showing bilateral testicular edema with concern for congestive heart failure (CHF). Computed tomography pulmonary angiography (CTPE) scan showed a large 6.51 cm thoracic aortic aneurysm (TAA), cardiomegaly with dilated left sided chambers, and a small pericardial effusion. Subsequently, …

Atypical Presentation Of Non-Aneurysmal Subarachnoid Hemorrhage, Aleks Spirollari, James Espinosa, Kevin Dwyer

Rowan-Virtua Research Day

When most clinicians think of subarachnoid hemorrhages (SAH), they think of “most severe headache of my life” as the most common chief complaint. However, it is only reported in about 70% of patients with SAH. Other symptoms may include nausea and/or vomiting, stiff neck, visual disturbances, loss of consciousness, weakness, and seizures. Patient history may involve previous SAH, hypertension, oral contraceptives in women, recent trauma, family history of intracranial aneurysms, history of smoking, alcohol, and drug use. However, there are atypical causes of SAH that may be missed upon initial evaluation for patients that may not have the above mentioned …

Case Study Of Pulmonary Embolism With Unusual Chief Complaint, Kajel Patel

Rowan-Virtua Research Day

Pulmonary embolism (PE) is a serious diagnosis that needs to be made in the Emergency department (ED). There are different categories of PE ranging from massive to non-massive/sub-segmental. Regardless of the categorization, the patient will need to be placed on anticoagulation. It is important to catch this diagnosis in the ED so further complications do no arise. Here is a case from the ED with a patient coming in with the chief complaint of acute right lower quadrant abdominal pain and was diagnosed with a pulmonary embolism.

Retrograde Thromboembolism From The Proximal Descending Thoracic Aorta Leading To Recurrent Acute Cerebrovascular Events, Mark Staroelsky, Akash Patel, Gregory Holland, Nishant Parikh, Peter Bulik

Rowan-Virtua Research Day

In the United States, approximately 800,000 individuals experience a stroke every year

Nearly 25% of strokes are recurrent

Cryptogenic strokes, or those with unknown causes after testing, make up a significant portion of ischemic strokes, as many as 32%

Retrograde thromboembolic events originating from the proximal descending thoracic aorta should be considered as a potential etiology in cryptogenic strokes

The appropriate management of embolic events from aortic atheroma needs further research

Here, we present a case of a 55-year-old male who had recurrent cryptogenic strokes whose origin was discovered to stem from retrograde embolic phenomena from atheroma located within the …

Syncope Or Seizure?, Joseph Heron, Kevin Dwyer

Rowan-Virtua Research Day

Syncope is a common complaint in the emergency departments, accounting for 1-2% of visits, and can approach admission rates of a staggering 85%. The causes and conditions can be numerous, ranging from benign to life threatening. A good background history can go a long way in determining the etiology of the patient’s syncope. We describe a case of an elderly male who presented with a reported chief complaint of seizures, another syncope-mimic seen in the emergency department. He had a history of CAD, HTN, AAA, and osteoarthritis but no prior history of cardiac arrhythmia, MI, or structural heart disease. The …

Spontaneous Conus Medullary Infarction In The Absence Of Cardiovascular Risk Factors, Bavica Gummadi, Jaffer Ahmed, Swarna Rajagopalan

Rowan-Virtua Research Day

Spinal cord infarction (SCI) is rare and most often occurs in individuals with predisposing cardiovascular risk factors and traumatic injuries

As there are no distinct diagnostic criteria for SCI, diagnosis is difficult in patients presenting without predisposing factors and is often mistaken for transverse myelitis.

Delay in early diagnosis contributes to the high case fatality rate of SCI.

This case highlights the importance of including SCI in the differential of a patient with acute paraparesis even in the absence of co-existing risk factors.

Case Report: Post-Partum Headache, Alaleh Ebrahimi

Rowan-Virtua Research Day

Cerebral venous sinus thromboses are rare and occur in 5 people/1,000,000, more commonly in women that are pregnant at about 202/100,000 deliveries with an 11.63% mortality rate. It is believed that pregnancy being a hypercoagulable state is one of the main reasons that it is more common in pregnant and post-partum women. Common symptoms include sudden onset headache, blurry vision, focal neuro deficits, seizures and altered mental status.