UOTW #71

This patient is a 61 year old female with a history of hypertension and diabetes who presents with 3 weeks of intermittent exertional left sided chest pain. The pain is dull, non-pleuritic, always comes on when walking around and resolves with rest. +shortness of breath. Vitals: 95/50 125 22 98.6 97% RA. What diagnosis is suggested by the following bedside echo, and what can be measured to clinch the diagnosis?


Answer

9 thoughts on “UOTW #71

  1. Right ventricular dilatation and dysfunction, consistent with pulmonary embolism.the ECG also suggest the same diagnosis: sinusal tachycardia,Q3T3, right precordial T negative waves consistent with right ventricular strain
    The useful blood test is D-dimer

  2. of course I agree, D-dimer does not rule out, I did not mean that!
    I misunderstood the question “what can be measured”, as a blood test. In this case an useful echo measure is the PAPS: if less than 60mmHg it confirm that the right ventricular dilatation and dysfunction are acute

  3. Hi Dear Coleagues,
    RV is dilated and in strain; I can not measure TAPSE of course but it seems to be small; now I can measure Tricuspid Regurgitation and if it is more than 2.5 m/s then we have significant PAP(bernouli formula 4V^2)and if the RV wall is less than 6 mm then we have acute corpulmonale most probably due to PTE.

  4. McClonnelle’s sign with relative preserved right ventricular apex contractility with dilated RV and dyskinesia of RV lateral wall and D shape on PSX view on echo

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