The following ECG is from a 56-year-old lady who presented with chest pain and dyspnoea.
Her observations are as follows BP 90/55, RR 28, Sats 90% RA, Temp 37.7
Interpret her ECG, provide your differential diagnosis and rationale.
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Lab case 445
85 year-old-woman with fracture of right neck of femur. Her blood gases showed the following:
PH = 7.51
pCO2 = 59.5 mmHg
pO2 = 70 mmHg
HCO3 = 47.5 mmol/L
Lab case 436
58-year-old lady with history of obstructive sleep apnoea presented with Syncope. Her venous blood gases showed the following:
PH = 7.391
pCO2 = 57 mmHg
Lab case 431 interpretation
Answers:
Question 1:
PH = 7.58, that is severe alkalaemia.
pCO2 = 20 mmHg, so we have respiratory alkalosis. Next we need to calculate the compensation. From the story, the condition is most likely acute.
Lab case 425
51 year old man, recently returned from the middle east, presented with shortness of breath. His CXR was normal. His arterial blood gases showed the following:
PH = 7.51
PaCO2 = 28 mmHg
PO2 = 56 mmHg
Lab case 422
75 year old lady presented to the emergency department after a fall. In ED she was found to be slightly febrile with blood pressure of 95/55. Part of the investigation performed was LFT and it showed the following:
Bilirubin = 101 umol/L (< 16)
Lab case 419
32-year-old man presented to ED with an exacerbation of his asthma. On 3L O2, his arterial blood gases showed the following:
PH = 7.32
PO2 = 101 mmHg
Lab case 418
65 year old lady with history of progressive supranuclear palsy presented with aspiration pneumonia. Her venous blood gases showed the following:
PH = 7.315
pCO2 = 48 mmHg
pO2 = 48 mmHg
Lab case 415
A 45-year-old man presents with vomiting and numbness on his fingers . He has CML and he is on chemotherapy. His blood biochemistry showed the following:
Na = 130 mmol/L
K = 6.8 mmol/L
Lab case 410
80 year old lady presented with recurrent vomiting after colonoscopy. Her venous blood gases showed the following:
PH = 7.56
pCO2 = 34 mmHg