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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 > > > > This message has been scanned for viruses by BlackSpider MailControl - > www.blackspider.com >