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A Fatal Rectus Sheath Hematoma After A Myasthenia Crisis Case Report, Robert G. Michaud, Lesley B. Gordon

Journal of Maine Medical Center

Introduction: Rectus sheath hematomas (RSH) generally occur due to damage to the inferior epigastric artery. They are rare causes of abdominal pain or acute blood loss anemia, but are an important diagnostic consideration because they can be cryptic and are potentially fatal.

Clinical Findings: An 85-year-old female who had been admitted to the hospital for 10 days with a myasthenia crisis was found to be abruptly hypotensive with a tender abdominal mass in the left lower quadrant subtly crossing midline. She was on prophylactic anticoagulation during her hospitalization.

Main diagnosis, therapeutics, interventions, and outcomes: The patient was initially stabilized with …

Listen To Your Heart, Or At Least Theirs: Maintaining A High Index Of Suspicion For Infective Endocarditis, Mollie Powell Do, Mahesh Setty Md

Emergency Medicine

After an endothelial injury, a fibrin and platelet cap forms. This cap is typically sterile but in times of infection can become colonized by microbes leading to a vegetation. When this occurs on the endothelium of the heart, it is termed infective endocarditis (IE). IE is a difficult diagnosis to make in the ED. The symptoms are vague. Classic exam findings are often absent, murmur auscultation can be challenging and there is not a single diagnostic test. A delayed or missed diagnosis can be fatal; therefore, it is essential that ED physicians maintain a high index of suspicion in high …