Infective endocarditis diagnostic criteria / Endocarditis infecciosa, criterios diagnósticos.

Criteria can be quickly summarized in: Major clinical criteria (or pathological criteria) – Evidence of either valve damage or evidence of microorganisms within the bloodstream: Positive ecocardiography for infective endocarditis: vegetation, abscess, dehiscence of prosthetic valve. 2 separated positive blood cultures for typical IE microorganisms, or a single one for Cox. Burnetti. Minor clinical criteria…

Acute calculous cholecystitis / Colecistitis aguda calculosa.

Acute cholecystitis (inflammation of the gallbladder) results from injury from a gallstone, like impactation or cystic duct obstruction. Sometimes inflammation occurs without gallstone disease due to infection of bile (acalculous cholecystitis). The main difference between a patient who complains from abdominal pain and suffers from uncomplicated gallstone disease and acute cholecystitis is the evidence of…

Gallstone disease in adults / Cólico biliar en el adulto.

Abdominal pain is very common in the emergency department. Plenty of times patients complain of pain, but the physical examination results completely normal. Because of WHERE it hurts (upper right quadrant), suspicion of gallstone diseases rises. Things get tricky when lab results are normal, and the possibility of a final diagnosis in the ED disappears…

Management of COPD exacerbations

Patients with a chronic pulmonary obstructive disease will suffer exacerbations from time to time. It’s defined as an increase in symptoms beyond the normal day to day variability that then leads to a change in medication. It may also be defined as a worsening of the usual dyspnea, wheezing, tight chest feeling, coughing and expectoration…

Lower extremity vascular disease:

Peripheral artery disease vs. deep venous thrombosis: PERIPHERAL ARTERY DISEASE (PAD).- Due to arterial stenosis. Associated with heavy and prolonged tobacco use and atherosclerotic disease. Reduce blood flow will cause signs and symptoms such as weak pulses, pallor, cold skin, ulceration and of course lower extremity pain that increases with exertion up to the point…

Thrombotic microangiopathy and hemolytic anemia:

It’s all about damage of endothelium of small vessels (micro-angio-pathy). This will cause red blood cells to “crash into” inflamed walls, break (hemolytic anemia) and trigger clot formation (thrombotic). Anemia will cause hypoxemia and then thrombosis leads to reduced and impaired blood flow, tissue hypoxia, infarction and a suggestive clinical picture: petechiae, purpura, pain, organ…

STEMI vs NSTEMI

Myocardial infarction / Infarto agudo de miocardio: The following illustration reviews the pathological and ECG differences between a myocardial infarction without and with ST segment elevation. Patients will visit the ED with chest pain compatible with angina pectoris, and will require assessment of atherosclerotic and cardiovascular disease risk. This will be reviewed in future posts….