The American journal of emergency medicine
-
Pheochromocytoma is a rare tumor that usually develops ahead of the neuroectodermal chromaffin cells of the adrenal medulla, but it may arise anywhere within plexus of sympathetic adrenergic nerves. Headache, palpitations, tremor, excessive sweating, abdominal pain, and hypertensive paroxysm are the common clinical presentations of the tumor, but it has also been reported several cardiac symptoms.
-
We hypothesized that isolated gastrointestinal complaints (abdominal pain, nausea, anorexia, weight loss), in the absence of other symptoms, were a common mode of initial presentation in children with congestive heart failure (CHF). ⋯ Abdominal complaints are a common component of the presenting symptom complex of CHF in pediatric dilated cardiomyopathy in all age groups. In adolescents, abdominal complaints occur more frequently than respiratory complaints and often in the absence of any other symptoms. Unlike CHF in adults, chest pain, arrhythmia, or cardiac arrest occurs rarely at presentation in pediatric patients. Recognition of the different presenting symptoms of heart failure in children by primary providers is crucial to ensuring prompt diagnosis and timely initiation of therapy.
-
Case Reports
Bilateral hippocampal abnormalities in magnetic resonance imaging in transient global amnesia.
Transient global amnesia (TGA) is an isolated amnesic syndrome with normal neurologic examination. Patients remain alert and communicative with no loss of personal identity; however, they experience striking loss of memory for recent events and an impaired ability to retain new information. We report a case of TGA in a patient with acute ischemia in bilateral hippocampal abnormalities. This provides evidence in support of an ischemic hypothesis as the possible etiology of TGA.
-
The objective of this study is to review the mortality after discharge in clinically stable infants admitted with a first apparent life-threatening event. ⋯ The risk of subsequent mortality in infants admitted from our pediatric ED with an ALTE is substantial. Emergency physicians should consider routine admission for patients with ALTE.
-
The purpose was to determine the proportion of alcohol-positive (AlcPos) trauma patients in different age groups and any association with mortality using the National Trauma Data Bank. ⋯ Trauma patients of all ages may be AlcPos. Being AlcPos is a marker for greater injury in all age groups. After controlling for ISSs, trauma patients 40 years and older who were AlcPos have increased mortality. This study suggests a role for alcohol testing in all age groups.