Case Report: A cardiac mass diagnosed using Point-of-care ultrasound in a dyspneic patient. An integrated ultrasound examination of lung-heart-Inferior Vena Cava

by Maria Viviana Carlino MD; Costantino Mancusi MD; Alfonso Sforza MD; Giorgio Bosso MD; Valentina Di Fronzo MD; Gaetana Ferro MD; Giovanni de Simone Prof.; Fiorella Paladino MD

A 74-year-old woman with history of hypertension presented to the Emergency Department (ED) with severe resting dyspnea and swelling in the feet, ankles and legs. She was on treatment with furosemide and a beta blocker. At the time of admission blood pressure was 145/88 mmHg, heart rate (HR) 99 bpm, regular, oxygen saturation was 89% (FiO2 21%) and respiratory rate was 17 breaths/min.

Case Report: Type 1 aortic dissection presenting as acute pericarditis: the roles of POCUS and transthoracic echocardiography

by Bill Ayach MD PhD; Aadil Dhansay MD1, Andrew Morris MD; James W. Tam MD; Davinder S. Jassal MD

A 59 year old male presented with a 1 day history of non-exertional chest pain that was pleuritic in nature and aggravated by lying flat. His chest pain symptoms were preceded by a one week history of “flu-like” symptoms. Physical exam demonstrated a blood pressure of 114/55 mmHg, heart rate of 75 bpm, and a normal oxygen saturation on room air. Cardiac examination revealed a biphasic pericardial rub vs. to-and-fro murmur.

Case Report: Early signs of tamponade may be detected by cardiac point-of-care ultrasound

by Michael Cenkowski, MD; Amer M. Johri, MD; Raveen Pal, MD; Jennifer Hutchison, RDCS

A 35-year-old male with a past medical history of end stage renal disease on hemodialysis and a chronic pericardial effusion secondary to dialysis presented to the Emergency Room (ER) with a 2-week history of a flu-like illness and pleuritic chest pain. He was compliant with dialysis three times per week. His blood pressure was 150/85 mmHg with a heart rate of 85 beats per minute and the remainder of his vital signs were stable. Pulsus paradoxus was not present.

Case Report: Pediatric POCUS: 4 month old infant with a timely diagnosis

by Victor Istasy MD, FRCPC; Tim Lynch MD, FRCPC; Rodrick Lim, MD, FRCPC

A healthy, four month-old female infant presented to a local emergency department with a 12-hour history of decreased activity, non-bilious vomiting and one episode of dark red blood in the stools. There was no history of fever. Telephone consultation was completed and the patient was transferred to a tertiary, pediatric centre for further evaluation. On arrival, the infant appeared pale and was lethargic during the exam.

Pilot Project: Does formal bedside training of medical students with a FAST exam increase their knowledge and comfort level with ultrasound use in a community family medicine practice setting?

by Rimi Sambi, MD and Heather Sawula, MD; Brent Wolfrom, MD; and Joseph Newbigging, MD

As point of care ultrasound (PoCUS) becomes increasingly popular and a standard of care in many clinical settings, the interest for integration in medical undergraduate curriculum is also growing. This project aims to assess whether formal bedside Focused Abdominal Scan for Trauma (FAST) exam training of medical students increases their knowledge and comfort with the use of bedside ultrasound in a family medicine setting at Queen’s University.