Rowley Cottingham wrote:
> Oh, good shout. I wanted the K+ and more details of that ECG - was the
> description given saying it was LBBB or suspicious of >2mm with a narrow
> QRS?
Will revisit it - been busy this week.
IIRC it was narrow complex, no LBBB, marked ST elevation ant/septal.
K+ was normal
Jel
>
> Best Wishes,
>
> Rowley.
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Fiona Wallace
> Sent: 27 February 2008 03:12
> To: [log in to unmask]
> Subject: Re: Clinical problem
>
>
> Addisonian crisis?
>
> GI upset and hypotension are classic presenting signs.
> I've seen one with a K+ of 5.0 who arrested and ended up
> in PVS. (Illness in kids could be a coincidence.)
>
> What was the metabolic component of her ABG?
>
> Fiona
>
> On Tue, 26 Feb 2008 17:49:20 -0800
> Jel Coward <[log in to unmask]> wrote:
>> Hi all
>>
>> Mid 40's female, seen a few days before the presentation
>> described, with D+V that her children also had.
>>
>> Had been drinking Gatorade and water - but the last day
>> just water - hardly eaten anything.
>>
>> Day before the presentation described - felt much better
>> in the morning but at lunchtime felt chilled/sweaty and
>> not so good in the afternoon.
>>
>> Presents at 7 am feeling unwell, bifrontal headache
>> (also present for a few days), low back pain (possibly on
>> and off for months.
>>
>> Possible FH of IHD
>>
>> PMH - nil significant.
>>
>> OE P 124 sinus tachy, BP 76/38 O2 sat 100percent. Pale
>> extremities and cool. Afebrile.
>> HS normal. No signs of DVT. Chest clear but RR 28. Abdo
>> unremarkable.
>> Neuro nil gross but co-operation difficult as some
>> headache and a bit distressed. No neck stiffness.
>> Possibley some photophobia in that vague sort of way that
>> seems to exist sometimes but might just be wanting to
>> check out of the hassles.
>>
>> Limited labs available.
>> WCC normal, Na 126 Glucose 7.6
>>
>> An hour and a half in mentions chest pain (had been
>> asked, I think) - started 3 am, at worst at 7am - then
>> went away - but now recurring and BP falls when it comes.
>> Is retrosternal, no radiation, not tearing.
>>
>> Chest pain recurs a few times over an hour or so and BP
>> drops further every time and then recovers to around the
>> above level.
>>
>> ECG - Sinus tachy with ST elev V1-3 and depression V5,6
>> (not sure of else)
>>
>>
>> Pathology?
>>
>> What to do?
>> --
>> Jel
>
>
>
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