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Veronica Morgan

EM@3AM: Takotsubo Cardiomyopathy

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A 67-year-old female with past medical history of hypertension presents with acute onset of chest pain without associated symptoms. She describes the pain as left-sided, non-radiating, and 9/10 in severity. On exam, vital signs are normal. She is clutching her chest and is in acute distress due to pain with no other remarkable findings. ECG shows ST-segment elevation in V3-V6 only with depression in aVR. Initial troponin is mildly elevated. The catheterization lab is activated, but catheterization shows no coronary artery occlusion. On further questioning, the patient denies recent illness but does mention that her daughter passed away in a car accident yesterday.  What is the diagnosis?

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EM@3AM: Suppurative Parotitis

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A 75-year-old male presents to the ED with right facial swelling since last night. He is also complaining of pain and subjective fevers. Initial vital signs include BP of 150/85, HR 103, T 100.8, RR 18, SpO2 97% on RA. Exam reveals the patient to be ill-appearing with a focal area of swelling medially to his right ear that is warm and tender to palpation. His oral mucosa is dry. He has multiple dental caries and poor dentition overall. Massage of the area of swelling reveals purulent drainage from the oral mucosa near the right maxillary molars.  What is the most likely diagnosis?

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