17 y f student C/o breathless since past 3 days No vomiting / fever / cough / cold - no other relevant medical history . Room air saturation - 68% - tachyapnea - pulse - 121 / min - diagnosis & further management ?



Decreased sPo2 with normal pO2 points towards carbon monoxide poisoning. Usually metabolic acidosis is seen in CO poisoning but hyperventilation may cause respiratory alkalosis. Go for carboxyhemoglobin estimation.

ABG showing only respiratory alkalosis. No hypoxia. Cxr normal. Do ECG.echo. What about auscultatory findings? Any h/o trauma or risk factor for pulmonary embolism ? May be infectious/pneumonia/bronchitis (although no signs of that) but CXR if done early may come normal. Any congenital heart disease( valvular heart disease)? Severe anaemia . Last if no clinical signs & findings , then it may be psychogenic.

Abg -metabolic alkalosis cardiac tamponade rule out embolism adv urgent echo sos CTPA

CML with Hyperleukocytosis

It's a case of respiratory alkalosis.

Auscultate the pt. If no wheezes or ronchi,(rule out asthma) then it goes mostly in favour of psychogenic.

What are the Echo & ECG findings? Also serum K+ & Ca+ is low. Serum Mg+ level also needs to be checked.

this is case of respiratory alkalosis

What about cardiac status.

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