BROADCASTS.com

CardioNerds\xa0(Amit Goyal\xa0&\xa0Daniel Ambinder) join\xa0University of Florida cardiology fellows (Ashley Mohadjer, Hussain Khalid, and Morgan Randall) for an authentic\xa0Gainesville-style\xa0tailgate! They discuss a fascinating case\xa0of severe peripheral artery disease (PAD) and\xa0cerebral hyperperfusion syndrome. Dr. Khanjan Shah provides the E-CPR and\xa0 a message for applicants.\xa0Episode notes were developed by Johns Hopkins internal medicine resident\xa0Richard Ferraro\xa0with mentorship from University of Maryland cardiology fellow\xa0Karan Desai.\xa0\xa0\n\n\n\n\n\nJump to: Patient summary - Case media - Case teaching - References\n\n\n\nEpisode graphic by Dr. Carine Hamo\n\n\n\n\n\n\n\nThe\xa0CardioNerds Cardiology Case Reports\xa0series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an\xa0\u201cExpert CardioNerd Perspectives & Review\u201d (E-CPR)\xa0for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus.\n\n\n\nWe are teaming up with the\xa0ACC FIT Section\xa0to use the\xa0#CNCR episodes\xa0to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an\xa0E-CPR\xa0segment and a message from the program director.\n\n\n\nCardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza\n\n\n\n\n\n\n\n\n\n\n\nPatient Summary\n\n\n\nA woman in her 60s\xa0with a past medical history of type 2 diabetes, hypertension, and hypothyroidism presented\xa0to the University of Florida\xa0with a chief complaint of "Someone told me my neck artery was blocked."\xa0 Someone call 227-346-6373.\xa0 What does that spell?\xa0CardioNerd!\xa0\xa0\xa0\n\n\n\nShe noted\xa0exertional\xa0pain in\xa0both\xa0legs\xa0with limited exertion.\xa0Has a family history of CAD and MI in her father in his 20s. Her only medications were baby aspirin, atorvastatin 80mg, and thyroid replacement. Her blood pressures were noted to be dropping and so her regimen was being titrated off as a result. Physical exam was notable only for poorly palpable pulses in all extremities. To further work this up, a myocardial perfusion scan, CTA head/neck/abdomen, and ABIs were ordered. ABI on the right was\xa00.86 and on the left was 0.76 with monophasic doppler waveforms throughout. CT abdomen exhibited an occlusion of the abdominal aorta from just below the renal arteries extending to the common iliac arteries\xa0with distal reconstitution. CT head/neck showed occlusion of the right carotid artery,\xa0complete occlusion of the right innominate artery, near complete occlusion of the right vertebral artery, and delayed flow in the right posterior cerebral artery. On the left side, she had high-grade subclavian stenosis. Myocardial perfusion imaging exhibited no defects.\xa0\xa0\n\n\n\nOn subsequent visits her exercise tolerance improved with an exercise regimen, but blood pressures were more and more difficult to obtain. As a result, revascularization was pursued with stenting of the left subclavian artery.\xa0She was discharged, but returned a few hours later with severe left sided pulsatile headache and nausea/vomiting.\xa0She was admitted for monitoring, but fortunately improved and\xa0discharged\xa0with\xa0close outpatient follow-up.\xa0 She continued to improve in the outpatient setting. After MRI brain and extensive work-up, she was deemed to have cerebral\xa0hyperperfusion\xa0syndrome following revascularization.\xa0 She had no further complications and was monitored thereafter.\xa0\xa0Final diagnosis: severe peripheral artery disease (PAD) and\xa0cerebral hyperperfusion sy...