Chapter

Case 32

John Stradling, Andrew Stanton, Najib Rahman, Annabel Nickol and Helen Davies

in Oxford Case Histories in Respiratory Medicine

Published on behalf of Oxford University Press

Published in print July 2010 | ISBN: 9780199556373
Published online November 2012 | e-ISBN: 9780191753299 | DOI: http://dx.doi.org/10.1093/med/9780199556373.003.032

Series: Oxford Case Histories

Case 32

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A 66-year-old lady originally presented to the emergency department with gradual onset of shortness of breath over a week. The relevant past medical history was of asthma, and her father died post-operatively of a pulmonary embolus aged 59. She was very ill with signs of pulmonary hypertension with a loud P2, raised JVP, tachycardia and hypotension. Her right ankle was minimally swollen. ECG showed right bundle branch block and right axis deviation. Breathing air, the PaO2 was 8.0kPa and the PaCO2 was 3.4kPa, indicating a large alveolar to arterial gradient for oxygen (7.8kPa). Her pulmonary arteries were enlarged on CXR.

Chapter.  2273 words.  Illustrated.

Subjects: Respiratory Medicine and Pulmonology

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