Also known as: Enlarged heart muscle disease
Nicole presents with multiple systemic symptoms including vomiting blood, bowel pain, liver failure, kidney failure, and clotting issues. The team initially suspects various causes but eventually discovers advanced dilated cardiomyopathy with an atrial myxoma (mass in the heart).
Also known as: Excess iron in the body
House discovers iron overload by noticing speckled imaging on the ultrasound. This condition is causing widespread organ damage and is ultimately traced to surgical pins in her brain affecting her sympathetic nervous system.
Also known as: Brain injury from pins
The root cause of Nicole's condition: surgical pins were placed in her brain as an infant during an attempted infanticide. One pin pressed on her sympathetic nervous center, causing signals to blood vessels that triggered multiple organ failures. Another pin affected her addiction center, causing her substance abuse issues.
Also known as: Intestinal tissue death from lack of blood flow
Nicole experienced ischemic bowel in China, leading Chinese surgeons to remove a foot of bowel. This was caused by hypoperfusion from the brain pin affecting her sympathetic nervous system and blood vessel function.
Also known as: Blood clot in liver vein
Nicole developed a blood clot in the hepatic vein causing acute liver failure. Chase performed emergency clot removal to save her liver function.
Also known as: DIC
Nicole develops DIC with both bleeding and clotting simultaneously, requiring multiple units of fresh frozen plasma. The team initially suspects cancer as the cause.
Also known as: Kidney failure
Nicole develops acute kidney injury with brown urine, initially thought to be unrelated to her other symptoms but eventually understood to be part of the systemic multi-organ dysfunction.
Also known as: Fluid-filled cyst in pancreas
An eight-centimeter fluid-filled cyst is discovered in the head of Nicole's pancreas. The team debates whether this is causing her multi-organ symptoms and considers it may be connected to other organs like a 'steamroller,' but ultimately it's a secondary finding.
Also known as: Alcohol withdrawal
Nicole experiences alcohol withdrawal with delirium tremens causing muscle twitching that interferes with medical procedures. She is placed in a phenobarbital coma to treat the DTs and allow the diagnostic procedure. Her addiction is later explained by a brain pin pressing on her addiction center.
Also known as: Alcoholism
Nicole has a long history of alcohol addiction with multiple attempts at recovery and family interventions. It is ultimately revealed that a surgical pin in her brain has been pressing on her addiction center, causing her substance abuse issues.