Difficulty Breathing

81-year-old male presented to the ED complaining of difficulty breathing over the last several days. He denies being around anyone positive or high risk for COVID-19. He further denies any chest pain. Initially his SpO2 is 75% on RA. During your assessment you note +2 edema in the peripheral lower extremities. The patient denies any history of CHF. Shortly after the patient becomes unresponsive with a 10 second period of asystole on the monitor. Quickly regains consciousness with a rhythm of sinus brady. Below is the ECG. Now it’s your turn. What would you like to know and what is our course of action? PMH of Diabetes CKD Hyperlipidemia Cerebral aneurysm HTN. What do you see?


Ecg shows complete heart block Bradycardia Xray chest shows lt obscured basal zone likely synpneumonic pleural effusion Cardiomegaly noted Hilar lymphadenopathy b/l Rt lower segmental collapse with trachea shift to rt As PMH of DM2T Ckd htn etc pt is in CCF with collapse rt loer base and pleural effusion lt side

Thanx dr Jagan Neethi

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Low voltage complex. ST elevation seen in inferior leads with reciprocal changes in anterior leads. Findings sugg of inferior wall MI. Cxray shows ? Cardiomegaly Left sided moderate pleural effusion.

Inferior wall MI with cardiomegaly And lt sided pleural effusion. Regular monitoring and constant evaluation required.

Thanks Dr Sandeep Ghodekar

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ECG is s/o iwmi with resiprocal changes in precordial leads. CXR PA view is showing lt sided pleural effusion.also the aortic knuckle is more prominent.do trop i,pleural tapping ,pleural fluid for cyto bio GS,urine RM,urine 24 hrs protien. What is his BP? What about his JVP Is there any murmer? As information provided above,it may be severe MS,do 2 D echo

ECG shows Acute STEMI in IW Complete heart block. Xray chest shows cardiomegaly, left pleural effusion, Kerle B lines indicating LVF Impression CAD, Acute IWMI, , CHB, CCF Stokes Adam episode

It's a case of STEMI st elvatin 111 avf.pl get his cardiac enzymes. Pl go for 2d echo.he is in cardiac failure. Inj lasix .double antiplatelet agents. LMWH. After lab & 2d reports thrombolysis. Coronary intervention after a cardiologist gives his opinion pl go for serial ecgs

Inferior wall M I Lt pleural effusion Regular & constant evaluation is required

Ecg af with controlled vent rate x-ray bilat pleural effusion

Low voltage complex Inferior wall MI Cardiomegaly Left lower pleural effusion CCF

Acute inferior wall mi with chb.cardiomegaly with bilateral pleural effusion,L>R,and pulmonary oedema.

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