A Zebra Among Horses: A Case of Brugada Syndrome and Coronary Artery Disease.

Brugada syndrome (BrS) is recognized as a hereditary ion channel disorder with electrocardiographic changes. First appearing in the literature about 20 years ago, contemporary thoughts are that BrS may be responsible for many sudden cardiac deaths and is associated with ventricular dysrhythmias that can lead to syncope or cardiac arrest. Many individuals with BrS may have no or limited structural heart disease, whereas others may have subtle morphological changes in histopathology. This case reviews a single patient with BrS Type 1 who was found to have a high-level of coronary artery disease. Changes noted in the original electrocardiogram were of significant importance in reaching the diagnosis.

Near-Miss Discharge of an Older Adult Male With Central Cord Syndrome.

Acute traumatic central cord syndrome (ATCCS) occurs in more than 11,000 individuals annually. A common cause in older adult is a low-velocity hypertension neck injury. This article reviews ATCCS from the perspective of an older adult who, after a fall at his primary residence, sustained a facial laceration. Just prior to discharge, neurological deficits were noted, which required further investigation with magnetic resonance imaging. Subsequently, the findings required emergent surgical intervention. Emergency nurses should be familiar with muscle assessment, deep tendon reflex assessment, and nervous system dermatomes. The value of repeating the physical examination prior to discharge is discussed.