Syncope after dyspnea

Chief complaint A 61 y/o diabetic male presents with syncope after having dyspnea after exertion. He also complaits of nausea and vomiting. Description No history of any such episode in past. He is a chronic smoker. No other past history. Vitals Temp: 98.3° F, Pulse 120 bpm; BP: 130/100 mmHg; RR 31 bpm Oxygen saturation of 93% on two liters nasal cannula. Lab reports On arrival patient was diaphoretic, tachycardic, tachypneic ABG: pH : 7.26; pCO2 :17 mm Hg (35-45mmgHg) and pO2 : 115 mmHg (80-100mmHg), troponin : 1.3 ng/mL (< 0.01 ng/mL) Please help in the diagnosis and treatment.

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Syncope after DOE in diabetic, smoker with tachycardia and hypocapnea. Cardiac and pulmonary causes like CAD, heart failure, pulmonary embolism, sepsis, pneumonia need to be ruled out. Adv: ECG ECHO Chest radiograph

It is a very interesting case It is a case of pulmonary embolism X ray chest is showing guidewire used for thrombolysis of pulmonary embolism CT chest picture is showing over distended right ventricle - bright portion of right ventricle - it is massively enlarged and looking bigger than left ventricle. This is because pulmonary artery of blocked because of embolism The third picture is showing deep vein thrombosis Raised troponin value is also indicative of pulmonary embolism

Xray shows pulmonary embolism Ct shows block of pulmonary because of embolism its lead to pulmonary embolism Usg shows there is no proper supply of blood that is because of thrombosis Trop is raised So it's a case of pulmonary embolism See for hrct See for ct brain to rule out stroke See for 2decho See for blood report n esr See for ecg Cardiac enzyme And treat accordingly


Tnx Dr Ashok Leel sir

COPD Ecg is main Tropt positive Dislodge of infarct in brain Mri brain Serum electrolyte t3 t4 tsh

*Pulmonary embolism with cerebral Retinopathy and DVT Regular monitoring and constant evaluation required.

What about get his cardiac evaluation. 2d rule out neurological cause by mri brain with angiogram

Adv MRI brain to rule out acute ischemic stroke.

LVH. And. Atherosclerosis

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