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Articles 1 - 30 of 940
Full-Text Articles in Medical Specialties
Ep 64 - Operation No Noro: A Multidisciplinary Approach To Containing A Norovirus Outbreak In An Inpatient Rehabilitation Unit, Donika Marko, Roula Hilli, Priscila Bercea, Pamela S. Bozigar, Levi Launder, Stephanie Robertson, Trini A. Mathew
Ep 64 - Operation No Noro: A Multidisciplinary Approach To Containing A Norovirus Outbreak In An Inpatient Rehabilitation Unit, Donika Marko, Roula Hilli, Priscila Bercea, Pamela S. Bozigar, Levi Launder, Stephanie Robertson, Trini A. Mathew
Conference Presentation Abstracts
Norovirus is a highly contagious viral gastroenteritis and can rapidly spread in healthcare settings, particularly in congregate environments such as inpatient rehabilitation units. In March 2025, a cluster of acute gastrointestinal illness was identified on a 34-bed inpatient rehabilitation unit within a 150-bed acute care hospital. Eight patients developed: • Nausea • Vomiting • Diarrhea • Abdominal pain Due to shared spaces, communal therapy activities, and high patient interaction, rapid intervention was initiated to prevent further spread.
The Power Of Proximity: Driving Hand Hygiene Compliance Through Sanitizer Placement, Jennifer E. Jones, Eric Van Middendorp, Leanne Wendt
The Power Of Proximity: Driving Hand Hygiene Compliance Through Sanitizer Placement, Jennifer E. Jones, Eric Van Middendorp, Leanne Wendt
Posters
Hand hygiene is the cornerstone of infection prevention in healthcare settings and is particularly critical in the Neonatal Intensive Care Unit (NICU) where patients are highly vulnerable due to immature immune systems and frequent exposure to invasive procedures. Healthcare associated infections (HAIs) remain a significant cause of morbidity and mortality among neonates. Evidence consistently identifies proper hand hygiene as the single most effective intervention to reduce HAIs in NICUs. Despite its simplicity, compliance among healthcare workers is often suboptimal, influenced by factors such as workload and accessibility of hand hygiene resources.
Quality In Action: A Systematic Approach To Central Line Associated Bloodstream Infection Prevention, Jennifer E. Jones, Maggie Simons, Sherri Hoard, Gabriel Laney, Adam Nicholson, Victoria Springvloed, Tracy James, Erica Tuffs
Quality In Action: A Systematic Approach To Central Line Associated Bloodstream Infection Prevention, Jennifer E. Jones, Maggie Simons, Sherri Hoard, Gabriel Laney, Adam Nicholson, Victoria Springvloed, Tracy James, Erica Tuffs
Posters
Central line associated bloodstream infections (CLABSIs) are a major source of morbidity, mortality, and increased healthcare costs in hospitalized patients. Reducing CLABSI rates requires more than isolated interventions; it demands a coordinated, multi-disciplinary strategy that addresses clinical practice, workflow and organizational culture.
Isr 84 - Improving Documentation Accuracy Of Surgical Site Infection Prevention Bundles Using Implementation Science Frameworks, Laura Fraser, Lynn M. Sackett-Hodge, Michelle Schaeffer, Pamela S. Bozigar
Isr 84 - Improving Documentation Accuracy Of Surgical Site Infection Prevention Bundles Using Implementation Science Frameworks, Laura Fraser, Lynn M. Sackett-Hodge, Michelle Schaeffer, Pamela S. Bozigar
Conference Presentation Abstracts
Accurate documentation of Surgical Site Infection (SSI) prevention bundle components is essential for quality improvement and patient safety. In National Healthcare Safety Network (NHSN)-reported colon (COLO) and hysterectomy (HYST) procedures, incomplete or inconsistent documentation undermines bundle fidelity and limits evaluation of outcomes. This initiative aims to determine whether embedding evidence-based interventions within implementation science frameworks improves documentation accuracy and ensures sustainability.
Proactive Strategies For Catheter-Associated Urinary Tract Infection (Cauti) Reduction: Leveraging Audit Tools And Interdisciplinary Collaboration, Mica Blauw
Posters
Catheter-associated urinary tract infections (CAUTIs) are a known cause of harm to patients. Policies enforcing infection prevention measures may help minimize the risk of harm to patients, but written policies do not always translate to bedside practice. We implemented a proactive daily audit to increase awareness of, and compliance with, CAUTI prevention tactics.
Code Wet: Navigating Water Leak Mitigation And Remediation Behind The Red Line, Mica Blauw
Code Wet: Navigating Water Leak Mitigation And Remediation Behind The Red Line, Mica Blauw
Posters
Water leaks in the hospital setting are concerning because of the possibility of mold growthon porous materials such asdrywallthatmaylead toinfections. Water leaksbehind the line of demarcation in the surgical services suiterequire extra care during the remediation processdue to the high-risk nature of surgical patients. We navigated water leakmitigation and remediation in a surgical suite while keeping surgical operations funning safely.
Comparative Analysis Of Fixed Versus Variable Rate Of Regional Citrate Anticoagulation In Critically Ill Ecmo Patients On Continuous Kidney Replacement Therapy, Lisa Hall Zimmerman, Alexander Chen, Felcia Ivascu, Anthony Iacco, Jimmi Mangla, Wesley Barnes, Sean Masters
Comparative Analysis Of Fixed Versus Variable Rate Of Regional Citrate Anticoagulation In Critically Ill Ecmo Patients On Continuous Kidney Replacement Therapy, Lisa Hall Zimmerman, Alexander Chen, Felcia Ivascu, Anthony Iacco, Jimmi Mangla, Wesley Barnes, Sean Masters
Conference Presentation Abstracts
Background: Continuous kidney replacement therapy (CKRT) is the preferred dialysis modality for critically ill patients with hemodynamic instability. Anticoagulation is often necessary to deliver CKRT effectively and prolong the circuit lifespan. The Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guideline for acute kidney injury 2012 recommends regional citrate administration during CKRT for patients without contraindications to prevent filter clotting. Citrate works by chelating calcium and interfering with the activation of the coagulation cascade. This study evaluated effectiveness and safety of fixed (FIX) versus variable citrate rate (VAR) in critically ill patients receiving CKRT. Methods: This single-center, retrospective study evaluated …
Optimizing Patient-Facing Ai Chatbot Questions To Improve Readability And Actionability In Anesthesia Education, Sarah Kadado, Bianca Elias, Roy Soto
Optimizing Patient-Facing Ai Chatbot Questions To Improve Readability And Actionability In Anesthesia Education, Sarah Kadado, Bianca Elias, Roy Soto
Posters
In anesthesia, high patient anxiety and limited counseling time increase the need for clear, usable information. Artificial intelligence (AI) chatbots (e.g., ChatGPT) are increasingly used for patient anesthesia education. Many AI-generated responses exceed the recommended 6th-8th grade reading level for patient education information. Responses also often lack actionable guidance for patients. This study quantifies how optimizing patient-facing prompts improves readability, understandability, and actionability.
Anatomy Of Teamwork: Leveraging Peer Feedback To Build A Bespoke Team Charter Assignment, Emily Tenniswood, Stefanie Attardi
Anatomy Of Teamwork: Leveraging Peer Feedback To Build A Bespoke Team Charter Assignment, Emily Tenniswood, Stefanie Attardi
Posters
Post-COVID-19, students in our M1 Anatomical Foundations of Clinical Practice (AFCP) courses increasingly request faculty guidance or intervention in managing intra-dissection team conflict.
Perceptions Of Radiology Residency Staffing Models Across Years Of Training, Alex Zhang, Alexander Swantek, Adela Pouzar, Sayf Al-Katib
Perceptions Of Radiology Residency Staffing Models Across Years Of Training, Alex Zhang, Alexander Swantek, Adela Pouzar, Sayf Al-Katib
Posters
Case staffing is the primary method by which radiology residencies teach at the workstation. Despite this, the styles and methods for how staffing is performed have not yet been comprehensively described. Understanding these models and evaluating resident perspectives can inform best practices and enhance radiology education.
A Hidden Giant: Tee Superiority In Mrsa Endocarditis With A Massive Supravalvular Aortic Mass, Mohammad Abed Alhaleem, Nebras Abu Abed, Salman Muslem, Fatma Bisher, Nadeen Sukhon, Wehbi Hanayni
A Hidden Giant: Tee Superiority In Mrsa Endocarditis With A Massive Supravalvular Aortic Mass, Mohammad Abed Alhaleem, Nebras Abu Abed, Salman Muslem, Fatma Bisher, Nadeen Sukhon, Wehbi Hanayni
Conference Presentation Abstracts
Background: A 66-year-old male with MRSA bacteremia developed septic pulmonary emboli, sternoclavicular joint infection, and prosthetic knee infection. While initial TTE was negative, subsequent TEE identified a large supravalvular aortic vegetation necessitating surgical excision and valve repair, underscoring the diagnostic superiority of TEE and the need for early surgical consideration in complicated MRSA endocarditis. Case Presentation: A 66-year-old male with diabetes, hypertension, and prior knee arthroplasty presented with MRSA bacteremia complicated by septic pulmonary emboli, sternoclavicular joint infection, and prosthetic knee infection. He underwent debridement of the chest wall and knee prosthesis with cultures confirming MRSA. Initial transthoracic echocardiography (TTE) …
Avoiding Anchoring Bias In Lymphadenopathy: Metastatic Thyroid Cancer Mimicking Tuberculous Lymphadenitis, Giuliano Romano, Mitchell Schwocho, Jacob Morton
Avoiding Anchoring Bias In Lymphadenopathy: Metastatic Thyroid Cancer Mimicking Tuberculous Lymphadenitis, Giuliano Romano, Mitchell Schwocho, Jacob Morton
Conference Presentation Abstracts
Introduction The differential diagnosis for a new neck mass is broad and includes malignant, infectious, and autoimmune etiologies. A systematic approach incorporating history, physical examination, and diagnostic testing is essential when developing and narrowing down a differential. Case Presentation A 52-year-old man with a history of diabetes, asthma, ankylosing spondylitis on weekly etanercept, and GERD presented with a 2-day history of painless right-sided neck swelling. He denied fever, chills, weight loss, night sweats, dysphagia, dyspnea, cough, recent illness, or constitutional symptoms aside from mild fatigue. He had recently returned from a 1.5- month trip to Bangladesh and had self-discontinued etanercept …
Interventional Approach To Intermediate-High-Risk Pe: Catheter-Directed Mechanical Thrombectomy, Shreya Agarwal, Kirill Ruban, Ishan Kirti, Karina Ruban, Fadi Saab, Sujata Kambhatla, Pranay Gupta
Interventional Approach To Intermediate-High-Risk Pe: Catheter-Directed Mechanical Thrombectomy, Shreya Agarwal, Kirill Ruban, Ishan Kirti, Karina Ruban, Fadi Saab, Sujata Kambhatla, Pranay Gupta
Conference Presentation Abstracts
Acute pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. The clinical outcomes are largely determined by thrombus burden and its hemodynamic impact on the right ventricle (RV). Over the past decade, catheter-directed mechanical thrombectomy has emerged as a promising alternative for systemic thrombolysis for PE management, particularly in patients at high risk for major bleeding. This approach provides rapid mechanical debulking of thrombus without exposure to thrombolytics and has been associated with significant improvements in RV function and pulmonary artery pressures. We present a case of extensive bilateral PE successfully treated with mechanical thrombectomy, highlighting the …
Right Ventricular Involvement In Stress Cardiomyopathy: A Case Of Biventricular Takotsubo With Cardiogenic Shock, Ahmad Muhammad, Yazan Alkehef, Theodore Schreiber
Right Ventricular Involvement In Stress Cardiomyopathy: A Case Of Biventricular Takotsubo With Cardiogenic Shock, Ahmad Muhammad, Yazan Alkehef, Theodore Schreiber
Conference Presentation Abstracts
Introduction Takotsubo cardiomyopathy (TC) is characterized by transient left ventricular (LV) dysfunction following a stressor in the absence of obstructive coronary artery disease. We present a case of a less common variant with right ventricular involvement. Hospital course A 45-year-old woman with sickle cell disease and asthma presented with nausea, vomiting, abdominal pain, and fevers, one week after the death of her father. Examination revealed an irregular tachycardia. Labs demonstrated leukocytosis, elevated lactate, and markedly increased troponin. Chest imaging showed bilateral basilar opacities. ECG demonstrated atrial flutter with rapid ventricular response. She developed progressive respiratory failure requiring intubation. Repeat ECG …
Significantly Elevated Procalcitonin In Aki Reliable Or Not Reliable?, Sally Othman, Sujata Kambhatla, Chadi Saad
Significantly Elevated Procalcitonin In Aki Reliable Or Not Reliable?, Sally Othman, Sujata Kambhatla, Chadi Saad
Conference Presentation Abstracts
Introduction Procalcitonin (PCT) is a biomarker that helps distinguish bacterial infections from other causes of infection or inflammation and can be used as a helpful adjunct to clinical judgment to resolve diagnostic uncertainty. However, the reliability of procalcitonin goes down when a patient has Acute kidney injury (AKI). Yet is there any significance for procalcitonin if it is extremely high, in hundreds, same in our patient, despite the patient in AKI and can PCT still be used to help determine mortality along with all other markers, or independent from other markers. Case report 36 years old male with PMH of …
Device And Patient-Related Complications Of Renal Denervation For Resistant Hypertension: A Post-Marketing Analysis Of The Fda Maude Database, Sai Tharun Reddy Gopannagari, Kesava Manikanta Achuta, Divya Ganisetti, Towfiqul Chowdhury, Chadi Saad
Device And Patient-Related Complications Of Renal Denervation For Resistant Hypertension: A Post-Marketing Analysis Of The Fda Maude Database, Sai Tharun Reddy Gopannagari, Kesava Manikanta Achuta, Divya Ganisetti, Towfiqul Chowdhury, Chadi Saad
Conference Presentation Abstracts
Background: Renal denervation (RDN) has re-emerged as an adjunctive therapy for resistant hypertension following recent FDA approvals of ultrasound- and radiofrequency-based systems. While contemporary randomized trials report a favorable safety profile, real-world post-marketing data may capture a broader spectrum of complications. Methods: We queried the FDA Manufacturer and User Facility Device Experience (MAUDE) database from inception through December 22, 2025, using product code ‘QYI’ and brand names ‘Paradise’ (Recor Medical) and ‘Symplicity Spyral’ (Medtronic). Reports describing RDN procedures for resistant hypertension were included. Events were manually reviewed and categorized as vascular, device-related, hemodynamic/arrhythmic, neurologic, or other. When multiple events occurred …
When Optimal Therapy Becomes High Risk: A Risk-Benefit Framework For Beta-Lactam Desensitization In Life-Threatening Mssa Infection, Rana Amoush, Aaron Kobernick
When Optimal Therapy Becomes High Risk: A Risk-Benefit Framework For Beta-Lactam Desensitization In Life-Threatening Mssa Infection, Rana Amoush, Aaron Kobernick
Conference Presentation Abstracts
Background Beta-lactam antibiotics are preferred for invasive methicillin-sensitive Staphylococcus aureus (MSSA) infections, especially those involving prosthetic material. Management is challenging in patients with severe beta-lactam hypersensitivity, as alternative agents may be less effective or poorly tolerated. Limited guidance exists on reassessing desensitization risk when second-line therapies become untenable. Purpose To present a case-based risk-benefit framework for evaluating beta-lactam desensitization in medically complex patients with life-threatening MSSA infections. Methods We retrospectively reviewed a patient with recurrent MSSA prosthetic graft infection and severe beta-lactam hypersensitivity. Clinical decision-making was analyzed using a structured risk–benefit framework incorporating infection severity, therapeutic superiority of beta-lactams, tolerance …
Implementation Of A Multi-Institutional Enhanced Recovery After Surgery (Eras) For Elective Spine Surgery: Two-Year Michigan Spine Surgery Improvement Collaborative (Mssic) Experience, Anisse Chaker, Kylie Springer, Kari Jarabek, Michael Melhem, Heegook Yeo, Jian-Hui Hu, Jad Khalil, Kenneth Easton, Richard Easton, Doris Tong, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, Victor Chang
Implementation Of A Multi-Institutional Enhanced Recovery After Surgery (Eras) For Elective Spine Surgery: Two-Year Michigan Spine Surgery Improvement Collaborative (Mssic) Experience, Anisse Chaker, Kylie Springer, Kari Jarabek, Michael Melhem, Heegook Yeo, Jian-Hui Hu, Jad Khalil, Kenneth Easton, Richard Easton, Doris Tong, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, Victor Chang
Conference Presentation Abstracts
Introduction: Enhanced Recovery After Surgery (ERAS) protocols have been introduced to several surgical specialties with the intention to reduce peri-operative adverse events and improve various health-system quality metrics including length of stay and patient satisfaction. Though this has been studied in the setting of spine surgery, the vast majority are single institution protocols biased toward academic teaching hospitals. There is a paucity of literature studying the utilization of a multi-institutional ERAS protocols that is applicable to community hospitals without associated training programs. We present the Michigan Spine Surgery Improvement Collaborative (MSSIC) two-year experience implementing a multi-institutional ERAS protocol for elective …
Changes In Opioid Prescribing Patterns In Opioid Naive Patients Can Translate To Improved Outcomes In The Opioid Non-Naive Patients With Anterior Cervical Surgery: A Michigan Spine Surgery Improvement Collaborative (Mssic) Study, Anisse Chaker, Geoff Kahn, Michael Melhem, Jian-Hui Hu, Kari Jarabek, Heegook Yeo, Bhargav Ayloo, Trevor Ruesch, Adam Junn, Jad Khalil, Kenneth Easton, Richard Easton, Doris Tang, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, David Nerenz, Victor Chang
Changes In Opioid Prescribing Patterns In Opioid Naive Patients Can Translate To Improved Outcomes In The Opioid Non-Naive Patients With Anterior Cervical Surgery: A Michigan Spine Surgery Improvement Collaborative (Mssic) Study, Anisse Chaker, Geoff Kahn, Michael Melhem, Jian-Hui Hu, Kari Jarabek, Heegook Yeo, Bhargav Ayloo, Trevor Ruesch, Adam Junn, Jad Khalil, Kenneth Easton, Richard Easton, Doris Tang, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, David Nerenz, Victor Chang
Conference Presentation Abstracts
Introduction: Though often necessary for adequate analgesia after spine surgery, continued opioid use can lead to chronic dependency. The Michigan Spine Surgery Improvement Collaborative (MSSIC) has demonstrated in prior work the promise of utilizing a multi-institutional morphine milliequivalent (MME) cutoff for elective anterior cervical surgery in the opioid naıve population. However, the effect of this cutoff in patients who were already on opioids pre-operatively have not previously been studied. The goal of this study was to evaluate whether changes in prescribing patterns in the opioid naıve population would also translate to the non-naıve populations, and whether the non-naıve population would …
The Impact Of Covid-19 On Spine Surgery: Temporal Trends In Complications And Patient-Reported Outcomes Across A Statewide Cohort, Ali Mehaidli, Richard Easton, Ahmad Almaat, Gary George, Alqasim Elnaggar, Victor Chang, Doris Tong, Jad Khalil, Kevin Taliaferro
The Impact Of Covid-19 On Spine Surgery: Temporal Trends In Complications And Patient-Reported Outcomes Across A Statewide Cohort, Ali Mehaidli, Richard Easton, Ahmad Almaat, Gary George, Alqasim Elnaggar, Victor Chang, Doris Tong, Jad Khalil, Kevin Taliaferro
Conference Presentation Abstracts
Introduction: The COVID-19 pandemic caused major disruptions in elective surgical care, including spine surgery, due to widespread hospital restructuring and resource limitations. Although previous studies have examined surgical volumes and safety during the pandemic, limited data exist on how outcomes varied across multiple phases of the pandemic, especially in real-world, multicenter spine surgery populations. Material and Methods: This retrospective cohort study used data from the Michigan Spine Surgery Improvement Collaborative (MSSIC) to compare outcomes in patients undergoing lumbar or cervical spine surgery across four COVID-19 timeframes: pre-COVID (1/2019-2/2020), onset-COVID (3/2020-9/2020), active-COVID (10/2020-2/2022), and post-COVID (3/2022- 12/2022). Patient demographics, surgical characteristics, …
A Rare Convergence: Malignant Thymoma With Pericardial Invasion In A Brca2 Mutation Carrier With A Synchronous Breast Mass, Mahmoud Yacout, Mohammad Chisti
A Rare Convergence: Malignant Thymoma With Pericardial Invasion In A Brca2 Mutation Carrier With A Synchronous Breast Mass, Mahmoud Yacout, Mohammad Chisti
Conference Presentation Abstracts
Introduction Thymomas are rare epithelial tumors of the anterior mediastinum, accounting for < 1% of adult malignancies, with an estimated annual incidence of approximately 0.15 cases per 100,000 persons. Although often indolent, thymomas are malignant by definition and may invade locally, recur, and, less commonly, disseminate. They are classically associated with autoimmune conditions, most notably myasthenia gravis, yet their relationship with hereditary cancer syndromes remains poorly defined. Germline BRCA2 mutations are well established in the pathogenesis of breast, ovarian, pancreatic, prostate, and other malignancies through impaired homologous recombination DNA repair. However, an association between BRCA2 mutations and thymic epithelial tumors has rarely been reported. We describe an unusual case of invasive malignant thymoma with pericardial invasion in a BRCA2 mutation carrier, discovered concurrently with a synchronous FDG-avid breast mass suspicious for malignancy. Case Presentation An 85-year-old man with a history of CAD, hypertension, GERD, and prior radical prostatectomy presented with several months of unintentional weight loss and chronic diarrhea. During evaluation for recurrent appendicitis, imaging incidentally revealed a large anterior mediastinal mass measuring up to 7.9 cm with irregular margins. FDG-PET demonstrated moderate metabolic activity within the mass (SUVmax 3.8). CT-guided biopsy revealed a thymic epithelial neoplasm consistent with thymoma. There was no clinical evidence of myasthenia gravis. He subsequently underwent partial sternotomy with thymectomy. Pathology demonstrated a 6-cm type B2 thymoma with direct pericardial invasion, positive surgical margins (R1), and no regional lymph node involvement (pN0), consistent with pT2 stage III disease by the Masaoka–Koga system. Given high-risk features, adjuvant radiation therapy was initiated, with planned surveillance using PET imaging and circulating tumor DNA monitoring. Concurrent PET imaging identified a palpable FDG-avid right breast mass. Genetic testing revealed a pathogenic germline BRCA2 mutation. The breast lesion is currently undergoing diagnostic biopsy and surgical evaluation. Discussion Thymomas are malignant neoplasms with a predilection for local invasion. Type B2 thymomas carry a higher risk of recurrence, particularly in the presence of pericardial invasion or incomplete resection. Complete surgical excision remains the cornerstone of management, while postoperative radiotherapy is recommended in invasive or R1 disease to reduce locoregional recurrence. The coexistence of invasive thymoma and a germline BRCA2 mutation is exceedingly rare and raises questions regarding shared oncogenic mechanisms. While thymic epithelial tumors are not classically associated with BRCA mutations, DNA repair defects may contribute to tumorigenesis in rare malignancies. The presence of a synchronous FDG-avid breast mass in a male BRCA2 carrier further underscores the importance of comprehensive oncologic and genetic evaluation and highlights the need for multidisciplinary management in complex hereditary cancer presentations. Conclusion We report a rare case of malignant type B2 thymoma with pericardial invasion in a BRCA2 mutation carrier, identified alongside a synchronous breast mass suspicious for malignancy. This case highlights the potential intersection between thymic epithelial tumors and hereditary cancer syndromes, reinforces the importance of genetic evaluation in patients with multiple malignancies, and underscores the need for long‑term multidisciplinary surveillance. Further investigation is warranted to elucidate any causal relationship between BRCA‑mediated DNA repair dysfunction and thymoma development.
Severe Transvalvular And Paravalvular Aortic Regurgitation As Late Tavr Failure Successfully Treated With Percutaneous Therapy, Ashley Armstrong, Luca Halalau, Ivan Hanson
Severe Transvalvular And Paravalvular Aortic Regurgitation As Late Tavr Failure Successfully Treated With Percutaneous Therapy, Ashley Armstrong, Luca Halalau, Ivan Hanson
Conference Presentation Abstracts
BACKGROUND - Transcatheter aortic valve replacement (TAVR) is an established therapy for severe aortic stenosis. With improving long-term survival, late prosthetic valve–related complications are increasingly recognized. CASE SUMMARY - We report a 74-year-old man who presented eight years after TAVR with progressive dyspnea, orthopnea, and bilateral lower extremity edema, identified to be acute decompensated heart failure with a new diastolic murmur. Transthoracic echocardiography demonstrated severe aortic regurgitation. Subsequent transesophageal echocardiography identified concomitant severe paravalvular and severe transvalvular regurgitation of the bioprosthetic valve. Invasive hemodynamic assessment revealed acute volume overload with markedly elevated filling pressures, secondary pulmonary hypertension, and right ventricular …
Igg4-Related Aortitis Presenting As Intramural Hematoma Of The Descending Thoracic Aorta, Sarah Ibrahim, Tejasvini Khanna, Lark Steafo, Ioannis Karageorgiou, Judith Bateman
Igg4-Related Aortitis Presenting As Intramural Hematoma Of The Descending Thoracic Aorta, Sarah Ibrahim, Tejasvini Khanna, Lark Steafo, Ioannis Karageorgiou, Judith Bateman
Conference Presentation Abstracts
IgG4-related aortitis is a rare manifestation of IgG4-related disease and can closely mimic acute aortic syndromes, including intramural hematoma (IMH), on imaging. Isolated involvement of the descending thoracic aorta is particularly uncommon, and misdiagnosis may lead to unnecessary surgical or endovascular intervention. A 68-year-old man with extensive cardiovascular disease, including prior coronary artery bypass grafting, recent percutaneous coronary intervention with drug-eluting stent placement, permanent pacemaker implantation for complete heart block, and recent pulmonary embolism, presented with three days of chest pain, shortness of breath, and left lower quadrant abdominal pain. At presentation, he was receiving apixaban, aspirin, and clopidogrel. Computed …
Two Glands, One Problem: Navigating Fertility Treatment In Concurrent Nonclassic Congenital Adrenal Hyperplasia And Polycystic Ovary Syndrome, Paul Meram, Mary Show, Elliott Gappy, Ajaz Banka
Two Glands, One Problem: Navigating Fertility Treatment In Concurrent Nonclassic Congenital Adrenal Hyperplasia And Polycystic Ovary Syndrome, Paul Meram, Mary Show, Elliott Gappy, Ajaz Banka
Conference Presentation Abstracts
Background: Nonclassic congenital adrenal hyperplasia (NCCAH) caused by 21-hydroxylase deficiency is generally a milder variant of congenital adrenal hyperplasia characterized by partial enzyme activity and variable increases in adrenal androgen levels. Patients presenting with such a condition may present in adolescence or adulthood with symptoms such as acne, hirsutism, irregular menses, and infertility. These symptoms often overlap with those of Polycystic Ovary Syndrome (PCOS), creating challenges in differentiation and management. It is critical to differentiate between PCOS and NCCAH in females of reproductive age, as hyperandrogenism treatment depends on the underlying cause, such as adrenal, ovarian, or a combination of …
Spontaneous Coronary Artery Dissection In Postpartum: A Hidden Cause Of Maternal Myocardial Infarction, Riya Chhabra, Brian Renard
Spontaneous Coronary Artery Dissection In Postpartum: A Hidden Cause Of Maternal Myocardial Infarction, Riya Chhabra, Brian Renard
Conference Presentation Abstracts
Spontaneous coronary artery dissection (SCAD) is a tear in the coronary artery lining which decreases blood flow to the heart. SCAD is the leading cause of myocardial infarction in young to middle aged women, especially during and after pregnancy. While SCAD is often managed conservatively, patients are prone to complications like cardiomyopathy. This case underscores the importance of considering SCAD as a differential for postpartum women with chest pain. Furthermore, this case highlights the diagnosis and management of an atypical stress-induced cardiomyopathy with global hypokinesis following postpartum SCAD. A 37-year-old female postpartum for five weeks presented to our hospital with …
Immune Checkpoint Inhibitor-Associated Perioptic Neuritis, Neud Kiros, Alina Sinha, Anant Krishnan
Immune Checkpoint Inhibitor-Associated Perioptic Neuritis, Neud Kiros, Alina Sinha, Anant Krishnan
Conference Presentation Abstracts
Clinical History A 47-year-old male with history of stage IV gastric cancer on nivolumab presented with blurry vision worse at close distances. Binocular horizontal diplopia was found on exam. Fundus exam demonstrated 4+ disc edema and hemorrhage bilaterally. Recent head MRI was negative for leptomeningeal enhancement. MR venogram and MRI orbits with contrast were ordered as well as lumbar puncture. The patient’s next dose of immunotherapy was held. Opening pressure was normal, and MRV showed no evidence of dural sinus thrombosis. MRI of the orbits was positive for perioptic neuritis bilaterally, and the patient was started on a steroid taper …
A Pain That Wouldn't Sleep: Osteoid Osteoma Masquerading As Lateral Epicondylitis, Madelyn Bagley, Luca Halalau, Aimee Espinosa, Terrence Metz
A Pain That Wouldn't Sleep: Osteoid Osteoma Masquerading As Lateral Epicondylitis, Madelyn Bagley, Luca Halalau, Aimee Espinosa, Terrence Metz
Conference Presentation Abstracts
Osteoid osteoma is a benign osteogenic tumor that accounts for approximately 10% of all benign bone tumors and predominantly affects adolescents and young adults. It classically presents with nocturnal pain that responds dramatically to nonsteroidal anti-inflammatory drugs, a feature attributed to increased prostaglandin production within the nidus. The femur and tibia are most commonly involved, whereas upper extremity lesions are relatively uncommon. A 19-year-old male presented with nearly two years of chronic, progressive left lateral elbow pain and left wrist weakness. The pain was nocturnal, radiated along the left arm, and was markedly relieved by nonsteroidal antiinflammatory drugs. He was …
Novel Applications Of Coronary Cta In Patients With Intermediate Risk Of Cad, Ashley Armstrong, Luai Madanat, Robert D. Safian
Novel Applications Of Coronary Cta In Patients With Intermediate Risk Of Cad, Ashley Armstrong, Luai Madanat, Robert D. Safian
Conference Presentation Abstracts
Background: ACC/AHA guidelines provide class 1 and 2A recommendations respectively for coronary CTA and FFRCT in patients with chest pain and intermediate risk of CAD. We present a case in which novel applications of CTA excluded obstructive CAD, identified the correct diagnosis, and allowed optimization of medical therapy. Case: In a 72-year-old male with stable angina and HEART score 6, stress ECG was positive for angina and frequent PVCs (Fig 1A). Coronary CTA (Fig 1B) and FFRCCT (Fig 1C) showed non-obstructive CAD and intramyocardial bridging/severe systolic compression in the mid-LAD (Fig 1D). AI plaque analysis demonstrated a mixed plaque burden …
Leveraging State Of The Art Simulation-Based Education To Enhance Medical Student Interest In Internal Medicine And Cardiology, Mohamed Abdalaziz, Nicholas Mitchell, Ryan Madder
Leveraging State Of The Art Simulation-Based Education To Enhance Medical Student Interest In Internal Medicine And Cardiology, Mohamed Abdalaziz, Nicholas Mitchell, Ryan Madder
Conference Presentation Abstracts
Abstract Background: Early clinical exposure plays a critical role in shaping medical student interest, and therefore choice in medical specialty. Traditional curricula offer limited opportunities for hands-on engagement with cardiovascular decision-making and procedures. Simulation-based education may address this gap by providing immersive, low-risk learning experiences. Methods: An internal medicine resident and Cardiology fellow led, faculty-supported simulation curriculum was developed for third- and fourth-year medical students using a state-of-the-art simulation laboratory. Two 75-minute sessions were conducted over a two-month period, with a total of 27 students participating. The first session included a focused electrocardiography didactic emphasizing ST-elevation myocardial infarction (STEMI) recognition, …
Right Atrial Thrombosis In Behcet's Disease Presenting With Tricuspid Inflow Obstruction, Famta Basher Bisher, Thekrayat M. Asad, Sireen Shehadah
Right Atrial Thrombosis In Behcet's Disease Presenting With Tricuspid Inflow Obstruction, Famta Basher Bisher, Thekrayat M. Asad, Sireen Shehadah
Conference Presentation Abstracts
Introduction Behçet’s disease (BD) is a chronic multisystem vasculitis characterized by recurrent mucocutaneous, ocular, vascular, and neurologic manifestations. Cardiac involvement is rare but can be severe, with intracardiac thrombosis representing an uncommon and potentially life-threatening complication. Management is challenging, as first-line medical therapy may be limited by bleeding risk or hemodynamic compromise. Case Presentation A 26-year-old woman with a 9-year history of Behçet’s disease presented with two weeks of progressive dyspnea, palpitations, fever, fatigue, and cough. She denied chest pain, or syncope, or lower extremity swelling. One year prior, she had been hospitalized for pulmonary embolism and was found to …