Thursday, September 12, 2013

Ultrasound Competition WINNER for AUGUST

Dr. Laura Melville  AND Dr. Mike McMahon

Youngish F hx thombophilia, DVT, PE s/p IVC placement presenting to the ID for suprapubic pain sudden, back pain for a week and arrived hypotensive, diaphoretic and tachycardic.

Vitals 70systolic, HR 120s. sat 99%.

In ED bedside echo showed massively dilated >1:1 RV:LV and PSS showed D sign. This essentially diagnosed PE.

Arrival to ED. pt got intubated, pressors, recieved tPA in ED. She was admitted to the ICU and found to have bilateral PE's with RLL infarction.

4 days later:  Discharged. Placed on Xarelto. Pt extubated, off pressors, ECHO shows normal LV EF 62%, RV pressure = 50

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