Topic: Acute dyspnea
A 45 year old woman presents to the ER with severe, acute shortness
of breath that started after a ten-hour bus trip. Minutes after the
patient exited the bus, she felt severe chest pain in the left
lower side of the thorax, accompanied by dyspnea.
Patient’s past history: P4, A1, C3, D0. LMD previous week. Oral
contraconceptives. Smokes ten cigarettes per day, denies alcoholism
or drug use.
Physical examination: T:36.6°C, BP: 145/95mmHg, HR 120bpm, RR
40bpm. SatO2 76%. Restless, anxious patient. Thoracoabdominal
breathing, very low respiratory sounds. Cardiac sounds with gallop,
abdomen within normal limits. Achrocyanosis, lower extremities with
visible, varicose-vein pattern.
EKG: sinus rhythm, tachycardia , right ventricle overload, 2nd
degree bundle block, no indication of ischemia. D-dimer: 0.7µg/ml;
Fibrinogen:350mg/d
What condition is this patient showing?
Based on symptoms, the patient may be suffering from left sided heart failure.
For left side heart failure, due to inability to pump blood from left ventricle , blood flows back to lungs and leads to shortness of breath.
Risk factors are
Here, patient has high blood pressure , and diagnosed with 2 nd degree heart block..
Topic: Acute dyspnea A 45 year old woman presents to the ER with severe, acute shortness of breath that started after a...
Case #1 History of Present Illness: The patient is 42 year old Caucasian male with no prior cardiac history. He presented to the emergency room at Green River Hospital complaining of chest pain. This morning he notices some numbness and pain in his left arm. Later in the day he developed pressure in the chest. This gradually worsened throughout the morning until shortly before lunch when he was rating the pain at 8/10 in severity and decided to go to...