All Journals from Peter Stenhouse
58-year-old lady presented to the Emergency Department with a two-day history of shortness of breath and confusion, on a background of one week’s history of general malaise, vomiting, fevers and chills. Her past medical history was unremarkable except for a large, benign goitre. Systemic enquiry revealed no symptoms to suggest a focus of infection.
The portable chest x-ray (Figure 1) shows a widened cardiac silhouette. An endotracheal tube is in situ, indicating the patient is now intubated.
The ECG (Figure 2) shows sinus rhythm with widespread mixed convex and concave ST elevation, most notable in V4, V5 and the lateral leads. There is a suggestion of PR depression in the inferior leads.
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