Showing posts with label pulmonary embolus. Show all posts
Showing posts with label pulmonary embolus. Show all posts

Sunday, June 11, 2017

Image of the Month (From August/September 2013 Modern Resident)

Author: Michael Gottlieb, MD
Cook County Emergency Medicine Residency
Originally Published: Modern Resident August/September 2013

An 81-year-old man with PMHx of HTN, DM, HL and OA s/p right hip replacement presents to the ED with acute onset CP and SOB x 1 day. While watching TV earlier, he developed a sudden inability to catch his breath, as well as some poorly localized, pleuritic chest tightness on the right side of his chest. He initially attributed this to reflux, but when it did not improve he drove himself to the ED.

His initial vitals are: Temp: 98.2, HR: 56, BP: 132/78, RR: 28, O2 Sat: 89%. Upon examination, he is in moderate distress, appreciably tachypneic and has to stop halfway through his sentences to catch his breath. The remainder of his exam is significant only 2+ pitting edema bilaterally. Labs are pending, a chest X-ray is ordered and his ECG is shown below.