The Heart of the Matter: A Supraventricular Mystery

May 10, 2026

A 61-year-old male with a history of asthma and opioid use disorder presented to the emergency department with acute worsening of shortness of breath, chest pain and cough associated with blood tinged sputum for two weeks. The patient also endorsed chronic heroin use; last use was 1 bag of heroin around 24 hours prior to presentation. The patient denied use of anticoagulation, prior DVT or PE, travel, recent surgery, or known cancer history. The patient's initial EKG (Figure 1) is shown below (0224).

Veronica Gonzalez MD, Michael Hohl MD, Erica Dolph MD, Abish Kharel MD, & Ari Edelheit MD

The Heart of the Matter: Acute Pericarditis

May 10, 2026

44-year-old otherwise healthy male presents to the emergency department with chest pain. The pain started yesterday mid-day and is described as central and substernal with radiation across the chest and up into the throat. The patient also reports shortness of breath worse with deep breathing and exertion. The patient is incarcerated but otherwise has no historical risk factors for tuberculosis, pulmonary embolism, or cardiac disease. An EKG (Figure 1) is obtained.

Michael Hohl MD and Ari Edelhiet MD

Heart of the Matter: A Difficult Case of Atrial Tachycardia

April 22, 2026

The patient is a 52-year-old female, with a past medical history of hypertension, congestive heart failure, atrial fibrillation on rivaroxaban, and type 2 diabetes who is presenting with palpitations and shortness of breath for two days. Episodes last 1-3 minutes at a time before resolving. She has a history of similar symptoms the month prior, for which her cardiologist recommended an ablation in the future.

Emily Bovasso MD and Ari Edelheit MD

the County Consult