Abstract
PRESENTATION Never underestimate a patient’s willingness to alter the prescribed therapeutic plan. A 79-year-old man with a history of permanent atrial fibrillation was brought to the emergency department after 3 days of severe nausea and nonbloody/nonbilious emesis. He also reported a decrease in urine output, extreme fatigue, and worsening blurry vision with “flashing white lights.” Eighteen days prior to his presentation, he had a pharyngeal cyst removed and tracheostomy and gastrostomy tubes were placed. Postoperatively, his digoxin formulation was changed from tablet to an equivalent dosage of liquid preparation. He was discharged on postoperative day 8.
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