Hydronephrosis and aberrant renal artery

Images Evy Panos A 32 year old man presents with right loin pain after a drinking binge. His friends have urged him to attend the Emergency Department because he always complains of  right loin pain after drinking in their company and they would like him to get to the bottom of it. He describes having Read more about Hydronephrosis and aberrant renal artery[…]

Pulmonary Embolism – Right ventricular thrombus

Images Nick Stewart text Genevieve Carbonatto A 22 year old patient presents to the Emergency Department with calf pain. On further questioning she has had  a presyncopal event the day of presentation and complains of shortness of breath. She has recently been put on tranexamic acid for heavy menstrual bleeding. She is also on the Read more about Pulmonary Embolism – Right ventricular thrombus[…]

Cardiac tumour

Images Roger Burrell Text Genevieve Carbonatto A 60 year old man presented to the Emergency Department short of breath having a  known right ventricular cardiac tumour with metastases to the lung, liver, spleen and bone. On examination saturating 100% on RA, bilateral pitting pedal oedema, BP, 120/60, HR 68/min. An ECHO was performed in the Read more about Cardiac tumour[…]

Echocardiography during cardiac arrest

Text Genevieve Carbonatto The management of cardiac arrest has been intensively studied over the past 20 year and other than early and good quality CPR and early defibrillation in VF, very little has shown to improve the prognosis in cardiac arrest. The last 20 years has shown that high dose adrenaline, vasopressin, supplementary oxygen, treatment Read more about Echocardiography during cardiac arrest[…]

Pulmonary hypertension in a child

  Images Juan Chiang A 13 year old girl presents to the Emergency Department after a syncopal event at school. This was not associated with prior chest pain or SOB. This is her first syncopal event. ECG Chest Xray A point of care ultrasound is performed. The following clip shows shows her PLAX view followed Read more about Pulmonary hypertension in a child[…]

VSD in a 3 month old

Images Hanaho Imamura, text Genevieve Carbonatto A 3 month old girl is brought into the Emergency department. Her parents state that she has become more unsettled recently, not feeding as well and  appearing to be more short of breath with feeding. She is not settling with feeding, requiring to be fed every 2 hours and Read more about VSD in a 3 month old[…]

Coarctation of the aorta in a neonate

Images Chris Harrington, text Genevieve Carbonatto A 11 day old presents to the Emergency department in acute respiratory distress. His mother states that his SOB has increased markedly over the past 24 hours.  While on the way to hospital he has an episode of tachypnea  cyanosis and not breathing for 5 seconds. He has been Read more about Coarctation of the aorta in a neonate[…]

Stanford type B dissection

Images Earl Butler, text Genevieve Carbonatto A 55 year old lady presents with acute numbness to her right leg and “dizziness” lasting a few hours. No back pain. No chest pain. There are no other neurological symptoms.  BP 175/85 HR 72/min, RR 16/min saturations 96% on room air. A brain CT COW is organised and Read more about Stanford type B dissection[…]

Bacterial endocarditis : Mitral valve

Images Nick Stewart, text  Genevieve Carbonatto A 50 year old man presents to the ED with a 6 week history of general malaise, fevers, night sweats and weight loss (10 kg). He had been prescribed 7 courses of Augmentin by his GP and felt generally better on this antibiotic. An outpatient CT showed some nodes Read more about Bacterial endocarditis : Mitral valve[…]