FOAMed

EM@3AM: Dental Bleeding

A 38-year-old male with no history presents to the ED for dental bleeding. He was at the dentist earlier today for a simple tooth extraction but noticed that the bleeding has not stopped. He complains of only mild pain at the extraction site and has never had issues with bleeding before. On inspection of the bleeding site, it appears he had a right mandibular molar (Tooth #30) extracted with visible blood clots and active oozing. His airway is patent, breath sounds are normal, and the patient appears well-perfused. What is the diagnosis and your approach for bleeding control?

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EM@3AM: Mitral Regurgitation

A 63-year-old male presents to the ED complaining of sudden onset shortness of breath for the past 2 hours. He has a history of CAD, HTN, and T2DM He states that he has been compliant with his medications. BP 97/68, HR 108, RR 21, 92% RA. Physical exam is notable for a holosystolic murmur most prominent over the apex and radiating to the axilla, mild bibasilar rales, JVD, and 2+ lower extremity pitting edema. What is the most likely cause of this patient’s symptoms and what are the next steps in management?

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