Pulmonary Embolism

Question 1

The patient is a 52 year old male who presents to the emergency department with complaints of shortness of breath and chest pain that started suddenly. He describes the pain as a sharp, stabbing pain that worsens with deep breaths and movement.

Question 2

Explain the findings of the ECG and then state the most likely diagnosis for the patient

Answer 2

Pulmonary embolism
S1Q3T3

Question 3

Please describe the abnormalities in the ECG and state your most likely diagnosis

Answer 3

Pulmonary embolism
S1= a prominent S wave in lead 1
Q3= A deep

Question 4

A pulmonary embolism commonly blocks one or more branches of the blood vessel which carries blood from the heart to the lungs for oxygenation. Please state and point to this blood vessel

Answer 4

Pulmonary artery

Question 5

An ABG is taken from the patient:

The Arterial blood gas results are as follows:
pH–7.49 (7.35-7.45)
pO2 of 7.5 kPa (9.3 – 13.3)
PCO2 of 3.9 kPa (4.7 – 6.0)
Bicarb of 22 mmol/L (22-26)

Please state the findings of these results and what you can deduct from them.

Answer 5

Uncompensated respiratory alkalosis
The body’s compensatory mechanisms are unable to fully correct the pH imbalance. This is because the kidneys, which are responsible for regulating acid-base balance in the body, take longer to compensate for respiratory alkalosis.

Question 6

The patient is given a heparin sodium injection however later on the doctor notices that they have developed this rash.

Please explain why this has happened to the patient

Answer 6

Heparin-induced thrombocytopenia is an immune-mediated complication that can occur in some patients who are treated with heparin.