Group: 3

Case Nove0711

Eyas, Versha, Huong 1. Describe the chest x-ray finding. - Enlarged heart (left ventricular hypertrophy). - Left pulmonary edema. - Sharp Costo-diaphragmatic recess (no fluid in thoracic cavity). From the x-ray scan we denoted that a possible heart defect may have compromised pulmonary functions. 2. What does the blood gas show? Highlighted in the gas readings is a high pH value, with low pCO2, low bicarbonate which indicate chronic respiratory alkalosis with renal compensation. An increase in the chloride electrolytes explains a decrease in the bicarbonate due to the chloridebicarbonate exchanger in the red cell membrane. Oxygen saturation is low, indicating hypoxemia. 3. What does the CT demonstrate? - Necrosis. - Edema (acute issue which will gradually worsen). - Enlarged left ventrical. 4. Describe the ECG? - Possible first degree heart block. - Lengthened PR interval From the evidence presented, we discussed that the patient is presenting with a heart defect that has compromised the pulmonary system. It is apparent that the patient has left ventricular hypertrophy. The hypertrophy (viewed in EKG as heart block; might be congenitally related) has caused a buildup in the pulmonary blood pressure. Increased pulmonary blood pressure (with time) can lead to pulmonary edema, which decreases gas exchange, thus lowering oxygen saturation and initially decreasing pH. In response the patient is hyperventilating and thus depleting CO2 to increase pH (slightly alkalotic). This would explain the breathless patient.