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A Case of Rare Cause of DVT in the Young, Healthy Patient

A 44-year-old female comes to the ED with left lower extremity swelling. The patient notes increased swelling and discoloration to her entire left leg for three days, associated with aching pain. In a patient without any risk factors for thrombus or any other medical reason for hypercoagulability, what could cause an unprovoked left lower extremity thrombus?

em@3am

EM@3AM: Diabetic Foot Ulcer

A 58-year-old morbidly obese female patient with uncontrolled diabetes and peripheral arterial disease presents with an open wound to the central plantar aspect of her foot. She reports no pain, does not recall an injury, and is not sure how long she has had the ulcer. On exam, there is a 3.5 cm circular wound with thick yellow material in the center, and the edges of the wound are pink and warm to the touch. What is the diagnosis, and what are your next steps?

ultrasound

US Probe: E-Point Septal Separation (EPSS) in the CHF Patient

EPSS is a simple, easy to learn tool that allows a quick estimation of left ventricular function. The value of EPSS lies in its objective findings that do not require specialized training for interpretation and utilization, as shown by numerous studies. In patients without mitral or aortic valvular pathology, EPSS can be obtained from a single echocardiography view, providing quantifiable information on heart function within minutes. EPSS > 7mm is typically cited as the cut-off for abnormal ejection fraction (<50%). It offers a further tool for inexperienced emergency physicians that can be used to complement the overall assessment and risk stratification of patients with congestive heart failure.