Anyone with any medical knowledge, take a shot and help me out.
I'm an intern at a local hospital, meaning I do basic bitch work for all of the doctors and the nurses, but as I am a pre-med student, they give me case studies of recently diagnosed patients. Normally I'm pretty good at diagnosing them, but cardiology isn't my specialty. This isn't homework, it's just to help me get ahead of the curve. I figure out of 120,000 people, at least 10 have to be in the medical field, and out of 10, at least 1 will help me.
History: The patient, male; age 63, has a history of 3 myocardial infarctions, hypertension, and non-insulin dependent diabetes. He had an aorto-coronary bypass 1 year ago. Upon admission today, he presented shortness of breath which has been experienced occasionally over the past 3 months, but has been progressive over the past 5 days. The patient fatigues easily, has lost the energy to do daily tasks, and complains of anorexia. The patient has trouble sleeping due to lack of breath. He presents no chest or leg pain, or fainting spells. Upon examination, a bluish tint to his lips is discovered.
Vitals:
BP= 98/82mmHG
HR= 110/min
RR= 26bpm
Temp= 98 F
Course rhonchi and moist, inspiratory crackles are heard bilaterally in the lower lung fields. A grade 3/6 holosytolic murmur is heard best at the apex; it radiated to the left axilla. There is pitting edema of both lower extremities.
Chest X-Ray: "Marked prominence of the pulmonary vascular shadows (bilateral), bilateral pleural effusions, increased haziness and decreased radiolucency of the lung parachyma (bilateral), increased transverse diameter of the heart."
My first guess would be an acute myocardial infarction, due to his past history. But the absence of chest pain, and any pain to the extremities, makes me think otherwise. Due to the holostolic murmur and the edema of lower extremities, as well as a low blood pressure for someone of that age, it could be congestive heart failure, but I'm not sure. Anyway, take a shot at it if you want. If not, feel free to flame me all you want for whatever reason you so desire.
P.S. Why is S-T-@-B banned? As in "Take a S-T-@-B at it?"
I'm an intern at a local hospital, meaning I do basic bitch work for all of the doctors and the nurses, but as I am a pre-med student, they give me case studies of recently diagnosed patients. Normally I'm pretty good at diagnosing them, but cardiology isn't my specialty. This isn't homework, it's just to help me get ahead of the curve. I figure out of 120,000 people, at least 10 have to be in the medical field, and out of 10, at least 1 will help me.
History: The patient, male; age 63, has a history of 3 myocardial infarctions, hypertension, and non-insulin dependent diabetes. He had an aorto-coronary bypass 1 year ago. Upon admission today, he presented shortness of breath which has been experienced occasionally over the past 3 months, but has been progressive over the past 5 days. The patient fatigues easily, has lost the energy to do daily tasks, and complains of anorexia. The patient has trouble sleeping due to lack of breath. He presents no chest or leg pain, or fainting spells. Upon examination, a bluish tint to his lips is discovered.
Vitals:
BP= 98/82mmHG
HR= 110/min
RR= 26bpm
Temp= 98 F
Course rhonchi and moist, inspiratory crackles are heard bilaterally in the lower lung fields. A grade 3/6 holosytolic murmur is heard best at the apex; it radiated to the left axilla. There is pitting edema of both lower extremities.
Chest X-Ray: "Marked prominence of the pulmonary vascular shadows (bilateral), bilateral pleural effusions, increased haziness and decreased radiolucency of the lung parachyma (bilateral), increased transverse diameter of the heart."
My first guess would be an acute myocardial infarction, due to his past history. But the absence of chest pain, and any pain to the extremities, makes me think otherwise. Due to the holostolic murmur and the edema of lower extremities, as well as a low blood pressure for someone of that age, it could be congestive heart failure, but I'm not sure. Anyway, take a shot at it if you want. If not, feel free to flame me all you want for whatever reason you so desire.
P.S. Why is S-T-@-B banned? As in "Take a S-T-@-B at it?"
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