Image quiz: An old woman with a fava-bean in the heart
Journal
Hong Kong Journal of Emergency Medicine
Journal Volume
21
Journal Issue
3
Pages
189-191
Date Issued
2014
Author(s)
Abstract
A 62-year-old lady presented with a 5-day history of progressive dyspnoea to the emergency department. She had a medical history of hypertension and diabetes mellitus. On arrival, her heart rate was 82 beats per minute, respiratory rate 25 breath per minute, blood pressure 178/116 mmHg, SpO2 91% on room air. Her jugular venous pressure had risen to 8 cm. Auscultation revealed the high-pitched pansystolic murmur, grade III/VI in the lower left sternal border. Otherwise, the re s t o f her physical examination was unremarkable. A chest X-ray revealed cardiomegaly. An electrocardiography disclosed sinus rhythm. Arterial blood gas showed pH 7.499, PaCO2 30.2 mmHg, PaO2 53.6 mmHg, HCO3 23.0 mEq/L, SaO2 90.9% while she was breathing ambient air. N-terminal-pro brain natriuretic peptide (BNP) is 4317 pg/ml. Troponin-I was within normal limit.
SDGs
Publisher
Medcom Limited
Type
note