February 12th, 2014
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% […]
December 18th, 2013
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 […]
November 11th, 2013
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 wall […]
July 17th, 2013
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.
May 22nd, 2013
Choose your management approach and defend it.
May 1st, 2013
Offer your diagnosis of a 39-year-old man with severe pulmonary hypertension and markedly variable pulmonary capillary wedge pressures among lung segments.
March 27th, 2013
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 a […]
February 22nd, 2013
John Ryan, MD, James Fang, MD, James De Lemos, MD, Kamalendu Kanu Chatterjee, MBBS,FRCP, Thomas Ryan, MD and Rick Akira Nishimura, MD
Five experts offer their perspectives on a perplexing case involving a young physician patient.
February 1st, 2013
Jim Fang reflects on the changing landscape of academic cardiology and the evolving role of the physician investigator.
October 15th, 2012
A 91-year-old man with mild drug-controlled hypertension and atrial fibrillation has long-term, well-managed stability on warfarin anticoagulation. After developing problems with his balance and some gait instability, a physical exam reveals a carotid bruit. Carotid ultrasound and magnetic resonance angiography (MRA) confirm >95% stenosis of the right internal carotid artery. Brain CT is negative. Questions: 1. […]