The Medical Research Guide

In this post, I’ll walk you through how to write a case report using the example of my STRIATE-G technique case report.
A case report presents the clinical course of a single patient, highlighting unique diagnostic challenges, innovative treatments, or rare conditions. Following a clear structure will help you efficiently convey key points while ensuring the report is concise yet insightful.

I. Introduction to a Case Report

A case report focuses on a single clinical case, showcasing either a novel approach, rare diagnosis, or challenging scenario. It emphasizes lessons learned and innovative techniques that may benefit other clinicians. Case reports are particularly useful for sharing experiences with emerging procedures, as seen with the STRIATE-G technique during the COVID-19 pandemic.

This process can be divided into two key sections:

1. Actual Case
2. Discussion

II. Actual Case (1000–1500 Words)

In the Actual Case section, you should present the patient’s clinical journey from presentation to outcome. Below is a step-by-step breakdown using my STRIATE-G technique case.

Structure of the Actual Case

1. Patient Information
   • Demographics: Include the patient’s age, sex, and relevant medical history.
   • Medical History: Mention comorbidities that affected treatment or diagnosis.
   • Example: A 37-year-old male presented to the emergency department with chest pain and diaphoresis.
2. Chief Complaint and Presenting Symptoms
   • Describe the chief complaint and history of present illness (HPI). Include the onset, duration, and nature of symptoms.
   • Example: The patient described sudden-onset chest pain, radiating to the left arm, accompanied by shortness of breath. Symptoms began two hours before arrival.
3. Clinical Findings
   • Provide vital signs and relevant physical exam findings.
   • Example: The patient was tachycardic (HR: 120 bpm) with a BP of 150/90 mmHg. Cardiovascular examination revealed no murmurs or signs of heart failure.
4. Diagnostic Assessment
   • Include ECG results, labs, imaging studies, and how the diagnosis was reached.
   • Example: The ECG showed ST-segment elevation in leads V1-V4. Coronary angiography revealed a large thrombus burden in the proximal LAD, consistent with acute STEMI.
5. Treatment and Intervention
   • Describe the STRIATE-G technique and its implementation.
   • Example: The patient underwent primary PCI. Given the large thrombus burden, the STRIATE-G technique was used: stent retriever and aspiration thrombectomy was performed, followed by balloon angioplasty and stent placement.
   • Highlight challenges: The procedure was performed during the COVID-19 pandemic, requiring swift decision-making and adaptability.
6. Outcomes and Follow-up
   • Provide short- and long-term outcomes.
   • Example: The patient’s symptoms resolved immediately post-intervention. At the 3-month follow-up, no restenosis was observed, and the patient remained asymptomatic.
7. Key Takeaways (Optional)
   • Summarize key points in bullet format.
   • The STRIATE-G technique offers an effective alternative for managing large thrombus burdens in STEMI patients.
   • Innovative techniques can enhance outcomes, especially during challenging times like the COVID-19 pandemic.

III. Discussion (4–5 Paragraphs)

The Discussion section connects the case to existing literature, emphasizes its significance, and suggests future research directions.

Paragraph 1: Overview of the Topic
Provide background on thrombus management in STEMI using review articles.

• Example: Managing large thrombus burdens in STEMI remains challenging, with traditional aspiration techniques often yielding suboptimal results. Newer approaches, such as mechanical thrombectomy, offer promising alternatives.

Paragraph 2: How This Case Adds to the Literature
Highlight how the STRIATE-G technique advances current practice. If appropriate, include a comparison table with other reported cases.

• Example: This report is one of the first to describe the STRIATE-G technique for thrombus management in STEMI. Unlike standard thrombus aspiration, this technique uses stent retriever and aspiration thrombectomy to enhance clot extraction, reducing procedural time and improving outcomes. Table 1 summarizes similar cases and compares outcomes.

Paragraph 3: New Developments and Future Directions
Discuss ongoing research, such as the XXX trial inspired by this technique. Mention knowledge gaps and propose future research areas.

• Example: The XXX trial is currently investigating the efficacy of stent retriever thrombectomy in reducing thrombus burden in STEMI patients. Future studies are needed to determine the technique’s long-term outcomes and identify patient populations that will benefit the most.

Paragraph 4: Conclusion and Takeaways
Summarize the key clinical lessons from the case and discussion.

• Example: This case illustrates how the STRIATE-G technique can be a valuable tool for managing large thrombus burdens, especially during crises like the COVID-19 pandemic, where rapid and effective interventions are critical.

IV. Time Management Tips for Writing a Case Report

Efficient time management is essential.

1. Reading and Preparation (1–2 Hours): Read 5–6 relevant papers to familiarize yourself with the condition and management strategies. Take notes to avoid re-reading articles later.
2. Writing the Actual Case (1–2 Hours): Write the patient story and clinical course in one sitting to maintain a clear, chronological flow.
3. Writing the Discussion (3–4 Hours): Use bullet points to outline each paragraph before expanding them into full sentences. This will help you stay focused and ensure all key points are covered.
4. Review and Final Edits (1–2 Hours): Review the report for clarity and consistency. Ensure patient confidentiality and tailor the word count to match journal-specific requirements.

V. Final Thoughts on Writing a Case Report

A case report like my STRIATE-G technique publication offers valuable insights into innovative clinical strategies, especially during unprecedented times. While case reports may carry less academic weight for residents and fellows, they are excellent opportunities for medical students to gain publication experience.

Each journal has its own word limit requirements. I recommend writing the initial draft using the recommended word limits (in parentheses) and later tailoring the report to meet the journal’s specific criteria.

Key Takeaways

• Highlight unique aspects of your case and how they contribute to clinical practice.
• Use the discussion to connect your case with existing literature and propose future research directions.
• Manage your time efficiently to complete the report within 5–6 hours.
• Maintain a work-life balance and avoid overcommitting to writing.

By following this guide, you’ll be able to write a well-organized, high-quality case report that adds value to the medical literature and shares innovative insights with the broader healthcare community.

References

1. Yerasi C et al. The STRIATE-G Technique for COVID-19 ST-Segment Elevation Myocardial Infarction. JACC Cardiovasc Interv. 2021 Feb 8;14(3):345-346. doi: 10.1016/j.jcin.2020.09.045