The American journal of emergency medicine
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To evaluate the significance of sonographic perinephric fluid collection on the emergent management of patients with acute urinary stone obstruction. ⋯ This study shows a correlation between sonographic evidence of perinephric fluid and more severe pain. Therefore, an emergency physician can consider the evidence of perinephric fluid, in acute urethral stone obstruction, a predictor for more severe pain.
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Case Reports
Acute myocardial infarction in the setting of left bundle branch block: Chapman's sign.
Acute myocardial infarction (AMI) diagnosis in patients with pre-existing left bundle branch block (LBBB) can be difficult. Undiagnosed or delayed diagnosis of AMI in these patients can put them at risk of having shock, mechanical complications, and death. We present a case of 77-year-old Caucasian male with a known LBBB and coronary artery bypass surgery for coronary artery disease who presented to the emergency department with a chief complaint of chest pain and shortness of breath. ⋯ Troponin levels were initially normal, but serial troponin showed elevated enzyme giving evidence of acute coronary syndrome (ACS). The patient was started on heparin drip and underwent subsequent coronary catheterization. Physicians should be aware of Chapman's sign on ECG in patients presenting with chest pain who have baseline LBBB as it might represent myocardial ischemia and warrant emergent treatment for ACS.
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To investigate the role of fetuin-A as a potential biomarker for prognosis of fatality in patients with carbon monoxide (CO) poisoning. ⋯ The decrease of Fetuin-A may indicate an early signal for the progression of fatality due to CO poisoning.
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Left ventricular non-compaction (LVNC) is a cardiomyopathy with altered ventricular wall anatomy. This condition is characterized by the presence of prominent left ventricular trabeculae, a thin compacted layer, and deep intertrabecular recesses that are continuous with the left ventricular cavity and separated from the epicardial coronary. Left ventricular non-compaction can present with acute heart failure, arrhythmias, or sudden cardiac death. We present a case of a common cardiac arrhythmia in the emergency department with a work up consistent with LVNC being the underlying etiology.