Recognizing Hypoplastic Left Heart Syndrome in the Apical Four-Chamber View

This is an echocardiogram performed on a newborn male with prenatally-diagnosed hypoplastic left heart syndrome (HLHS). After being born at Loma Linda, the patient was admitted to the NICU. He was treated with prostaglandin E1 and nasal intermittent positive pressure ventilation (NIPPV). He then underwent a Norwood procedure. This is an apical four-chamber view showing …

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Acute Vision Loss

22 year old with no past medical history except for myopia and corrective lenses presents with acute painless monocular vision loss that began 2 days prior. He denies any recent trauma. He’s had a mild intermittent headache since onset, which prompted an outside hospital to order a CT scan, which had no abnormalities and he …

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A Sparkling Heart

56yo male, with history of systolic and diastolic CHF status post ICD, secondary to amyloidosis, presented to the ED with LLE swelling. Top differential diagnoses consisted of DVT vs. CHF exacerbation. No evidence of DVT on duplex ultrasound. CXR showed moderate right pleural effusion and atelectasis, and pacemaker leads in good position. A bedside echo/pulmonary …

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The IVC Clot

74 y.o. male with a 90 pack year smoking history who presented to the LLUMC ED w/ SOB for 2 days duration associated with a productive cough and palpitations. He initially presented to the Barstow ED with hypoxia (90% on RA) which improved with oxygen administration. Chest X-ray at the outside hospital showed a right …

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Pulmonary Hypertension and the D-sign on Ultrasound

A 31 y.o. female patient, with a history of Pulmonary Hypertension, Vasovagal Syncope, Dyspnea On Exertion, and Chronic Systolic Right Heart Failure, was admitted for Right Heart Catheterization secondary to Pulmonary Hypertension. The symptoms in this patient included: chronic cough, bilateral lower extremities edema, orthopnea, dyspnea, chest pain, dizziness, tachycardia, hoarseness, and diaphoresis. We performed …

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Longitudinal in plane line placement

79 year old female with a history of bladder cancer in her 3rd week of chemotherapy, atrial fibrillation, and hypertension, presented with altered mental status, diarrhea, generalized weakness. CT abdomen and pelvis from outside hospital revealed diverticulitis and labs revealed severe neutropenia and elevated lactate. Vitals in the ED showed fever, tachycardia, and hypotension with …

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