Current Issue

SCAD. Angiography. JETem 2026
Visual EM, Cardiology/Vascular, Current Issue

A Case Report of a 36-year-old Male Diagnosed with a Spontaneous Coronary Artery Dissection

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The initial ECG obtained from the patient shows subtle ST-segment elevation noted in leads I, aVL, and V2-V5, suggestive of pathology of the left anterior descending artery. The results of the catheterization revealed a spontaneous coronary artery dissection of the distal portion of the left anterior descending coronary artery, which can be seen in the image of the angiogram, with the diseased portion notated between the brackets.

Open Chest Wound. Photo. JETem 2026
Visual EM, Current Issue, Dermatology, Hematology/Oncology, Infectious Disease

Open Chest Wound with Sternal Fracture in the Emergency Department, a Case Report

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The image demonstrates the large chronic-appearing wound of the patient’s anterior chest as well as the visible fractured segments of the patient’s exposed sternum. The sternum is necrotic appearing concerning for a chronic process including osteomyelitis and malignancy. Purulent drainage is visible on the wound consistent with an infectious process.

Edema Bulla. Photo 1. JETem 2026
Visual EM, Cardiology/Vascular, Current Issue, Dermatology

Effects of Volume Overload: A Case Report of an Edema Bulla

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This image shows a large edema bulla on the patient’s right shin. The bulla is 10 x 10 cm, filled with serous fluid, has a spontaneously occurring defect in the skin of the superior portion of the bulla, and is non-erythematous. The bulla is much larger than the 1-5 cm edema bullae described in the literature. As edema bulla is primarily a clinical diagnosis, taking the full history and physical exam into account is essential to recognize these bullae.

Carotid Cavernous Fistula Photograph. JETem 2026
Visual EM, Current Issue, Ophthalmology, Procedures

A Case Report of Carotid Cavernous Fistula: A Commonly Missed Diagnosis

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The initial physical exam performed by the ED provider revealed severe left eye chemosis, clear drainage, visual acuity of right eye 20/100 and left eye 20/400, and a left eye IOP of 52. There was a deficit of extraocular movement in all directions of gaze and limitation in all visual fields in the left eye. The MRI showed that at the level of the eye, the left cavernous sinus is asymmetrically enlarged compared to the right (red arrow) with an enlarged left inferior petrosal sinus with internal flow void on the pre-contrast MRI images (blue arrow). The orange arrow notes a central filling defect of the left superior ophthalmic vein on the MRA.

Current Issue, Small Group Learning, Ultrasound

In Too Deep: A Point-of-Care Ultrasound (POCUS) Escape Room

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By the end of this session, the participant will be able to: 1) evaluate and identify the nature of metallic foreign bodies using POCUS; 2) identify common emergency department fractures on X-Ray and identify relevant sonoanatomy for ultrasound-guided regional anesthesia applications relevant to those fractures; and 3) identify normal lower extremity venous POCUS sonoanatomy and demonstrate understanding of proximal versus distal anatomical location within the lower extremity venous system.

Current Issue, Cardiology/Vascular, Certifying Exam Cases

Myopericarditis and Pulmonary Edema

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At the end of this oral board session, learners will be able to: 1) Demonstrate the ability to evaluate and treat a somnolent and hypoxic patient, 2) Identify a critical airway situation and manage it with a holistic approach, 3) Interpret the history, physical examination, ECG, and chest x-ray findings and discuss the list of differential diagnoses, 4) Identify a state of cardiogenic shock induced by myopericarditis and treat it appropriately, 5) Assess the presence of pericardial effusion and cardiac tamponade utilizing bedside echocardiography.

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