No abstract

No abstract

Cardiac amyloidosis is a disease process of abnormal amyloid fibril deposition in cardiac muscle that can be diagnosed by specific electrocardiographic and echocardiographic findings. We present the case of a patient with a history of cardiac amyloidosis who presented to the emergency department (ED) with shortness of breath, and was diagnosed with a large pericardial effusion by ultrasonography. The patient's myocardium exhibited a granular, "sparkling" appearance with increased echogenicity, typical for cardiac amyloidosis. We discuss the bedside ultrasound findings characteristic of this infiltrative cardiomyopathy, and how they influenced the ED management and treatment plan for this patient.

We present the case of an 8-year-old girl with two emergency department visits for constipation and abdominal pain. Her medical history and physical examination noted by the emergency physician did not reveal a clear etiology of her symptoms until the second visit, when a point-of-care ultrasound was performed. The sonographic findings were consistent with a fecalith surrounded by fluid concerning for appendiceal rupture. A computerized tomographic scan of the abdomen confirmed these findings in addition to two large abscesses in the lower pelvis, which subsequently required percutaneous drainage. This case illustrates the utility of point-of-care ultrasound in the evaluation of the pediatric patient with abdominal pain when appendicitis is a concern, as well as the ability of the emergency physician to use this technology to guide treatment and care of pediatric patients.

No abstract