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Cardiology Case Discussion

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Pulmonary Embolism in a Patient with Acute Decompensated Systolic Heart Failure (20 Mar 2014)

Ian Neeland, MD and James Fang, MD

Ian Neeland presents our latest case: A 42-year-old man with heart failure is found to have a large pulmonary embolus. Tell us how you’d manage his treatment.

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Case: Palpitations in a Young Runner with Lamin A/C Deficiency (3 Mar 2014)

Anna Catino, MD and James Fang, MD

Anna Catino presents our latest case: A young, male, long-distance runner experiencing palpitations, who has lamin A/C deficiency and a family history of cardiac disease. How would you manage this patient?

Avatar of Saurav

Case: Cardiorespiratory Arrest Requiring Intubation in a Patient with Diastolic Heart Failure (12 Feb 2014)

Saurav Chatterjee, MD and James Fang, MD

A 65-year-old African American woman with a history of hypertension, diabetes, and seizure disorder is brought to the ED via emergency medical services for respiratory distress requiring intubation. Two weeks earlier she was hospitalized for an exacerbation of acute diastolic heart failure; a transthoracic echocardiogram at that time documented an LV ejection fraction of 60%…

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Doc, Do I Really Need a New Battery? (18 Dec 2013)

Tariq Ahmad, MD, MPH and James Fang, MD

A 45-year-old man with nonischemic cardiomyopathy, diagnosed 8 years ago, presents for annual follow-up. A transthoracic echocardiogram (TTE), taken 3 years ago, showed an LV ejection fraction of 25%. Since then, the patient has improved a great deal and now has barely any signs or symptoms of heart failure. Repeat TTE right before the current visit showed an…

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Case: An Ironman with a Proximal Circumflex Lesion (11 Nov 2013)

John Ryan, MD, JAMES BECKERMAN, M.D., and James Fang, MD

A 48-year-old man who runs 4 to 6 Ironman races per year reports non-exertional chest pain and is referred for a stress echocardiogram. His two sisters suffered MIs and died in their fifties, and his brother underwent CABG at age 49. The patient goes for 17 minutes on the Bruce stress protocol, with lateral and anterolateral…

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A Surprising ICD Revision (17 Jul 2013)

Westby G Fisher, MD, James Fang, MD, and Edward J. Schloss, MD

An ICD removed from a 70-year-old man has a startling appearance. Explain what you think happened, and offer your approach for how to care for this patient.

Avatar of Indu Poornima, MD

Subdural Hematoma and Possible ACS After Syncope (22 May 2013)

Indu Poornima, MD and James Fang, MD

Choose your management approach and defend it.

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Which Wedge to Believe? (1 May 2013)

Tariq Ahmad, MD, MPH and James Fang, MD

Offer your diagnosis of a 39-year-old man with severe pulmonary hypertension and markedly variable pulmonary capillary wedge pressures among lung segments.

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Left to Our Many Devices, Which One Do We Choose? (27 Mar 2013)

Mark Dayer, MD PhD FRCP and James Fang, MD

A 63-year-old male smoker with type 2 diabetes presents for the first time with chest pain and shortness of breath at rest. He has no recent history of viral infection and no family history of heart failure or sudden cardiac death. Initial laboratory testing documents negative troponin, normal calcium, normal serum angiotensin-converting-enzyme (ACE) activity, and…

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Uncertain Thienopyridine Bioavailability After Bare-Metal Stent Placement (14 Jan 2013)

Payal Kohli, M.D. and James Fang, MD

How do you handle a patient with pheochromocytoma who is not absorbing antiplatelet therapy adequately after placement of a bare-metal stent?