J Emerg Med
-
Böhler's historical tuber-joint angle of the calcaneus has been used since 1931. Surprisingly, there is a paucity of literature on its use. ⋯ A Böhler's angle of 20° or less is highly accurate in determining the presence or absence of calcaneal fracture. Böhler's angle serves as a useful screening tool in fracture diagnosis.
-
Congestive heart failure (CHF) is a common Emergency Department (ED) disorder that accounts for >5 million ED visits annually. Although quite rare, patent ductus arteriosus (PDA) is a serious cause of CHF that if left untreated can lead to life-threatening sequelae, such as hypertensive pulmonary vascular disease, endarteritis, and aneurysms of the ductus. ⋯ Persistent PDA in adulthood is a rare but important cause of CHF with significant morbidity and mortality if not appropriately diagnosed and treated.
-
Necrotizing fasciitis (NF) is an infection of the soft tissue, and is fatal if not promptly and aggressively treated. Although it is rare, it is not exceptional; nevertheless, its presentation may be misleading and may delay the diagnosis. We highlight the possible synchronous development of NF in multiple noncontiguous areas. ⋯ "Synchronous" multifocality is not an expected presentation of NF, and it complicates the diagnosis and delays treatment, with a potentially negative impact on outcome.
-
Case Reports
Fatal Infant Myocardial Infarction Caused by Ball-IN-Valve Mechanism from a Dysplastic Aortic Valve.
Acute myocardial infarction (AMI) can occur in infants. Early identification of AMI can allow for specific therapies aimed at improving patient outcomes. ⋯ AMI is an important diagnostic consideration in any infant presenting with signs of unexplained cardiogenic shock. Practitioners who care for children should be aware of diagnostic and therapeutic strategies for AMI in infants.
-
Methamphetamine use is an increasing problem in the United States. Despite the similarities to cocaine in clinical presentation, methamphetamine effects on the cardiovascular system are not as clearly understood. ⋯ This study presents a large cohort of methamphetamine users. The study found that chest pain and myocardial ischemia were reported in a number of cases. Although no true incidence can be taken from this dataset, it provides a large-scale review of methamphetamine use and its possible association with acute coronary syndromes.