A 28 year old female presents to your Emergency Department with palpitations and shortness of breath. She has no chest pain and no significant past medical history.
On examination she is dyspnoeic with clear lung fields and good air entry bilaterally. She has a normal CXR.
PR 220/min SVT, which reverts to a sinus rate of 110/min after Valsalva
T 36.7 degrees celcius
Sats 84% on 15 litres non rebreather
Her Arterial gas:
pH 7.46 (7.36-7.44)
pCO2 27 (35-45 mmHg)
HCO3 19 (24 +/-2 mmol/l)
Hb 194 (115-135 g/l)
Na 143 (137-145 mmol/l)
K 3.7 (3.3 – 5 mmol/l)
Cl 115 (99-111 mmol/l)
1. Describe the abnormalities
2. Interpret the findings
3. What is the most important investigation?
Thanks to Shai for this great case