Case No. 23

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Case No. 23

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Chief Complaint:

Chest Pain and Shortness of Breath

Published: May 16, 2017
Case No. 23
Author: Jason2475
CASE SCENARIO

A 64 year old male with a history of hypertension, diabetes, and hyperlipidemia is referred to the Emergency Department by his primary medical doctor for evaluation of chest pain and shortness of breath. The pain is located in his mid-chest, is non-radiating, and is exacerbated by deep inspiration and exertion. His pain is sharp in quality. He has associated shortness of breath and fatigue. The patient recently returned from a trip in Europe (9 hour flight) approximately 4 days ago when the symptoms began. On arrival to the Emergency Department his vitals are HR 115, BP 125/84, RR 30, O2 Sat 92% on room air. The patient tells you his baseline blood pressure is in the 180-190 systolic range as he is non-compliant with his antihypertensives. The patient is put on a nasal cannula with improvement in his oxygen saturation. You obtain a CT angiogram of the chest which reveals pulmonary ebomoli in his R segmental and subsegmental arteries. Bedside echocardiogram reveals bowing of the interventricular septum.

QUESTION

How would you classify this patients pulmonary embolism?

Low-Risk PE
Submassive PE
Massive PE
Chronic PE