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Monday
Jan012018

January 2018 Critical Care Case of the Month

Theodore Loftsgard, APRN, ACNP 

Department of Anesthesiology and Critical Care

Mayo Clinic Minnesota

Rochester, MN USA

 

History of Present Illness

The patient is a 51-year-old woman admitted with a long history of progressive shortness of breath.  She has a long history of “heart problems”. She uses supplemental oxygen at 1 LPM by nasal cannula.

Past Medical History, Social History and Family History

She also has several comorbidities including renal failure with two renal transplants and a history of relatively recent RSV and CMV pneumonia. She is a life-long nonsmoker. Her family history is noncontributory.

Physical Examination

  • Vital signs: Blood pressure 145/80 mm Hg, heart rate 59 beats/min, respiratory rate 18, T 37.0º C, SpO2 91% of 1 LPM.
  • Lungs: Clear.
  • Heart: Regular rhythm with G 3/6 systolic ejection murmur at the base.
  • Abdomen: unremarkable.
  • Extremities: no edema

Which of the following should be performed? (Click on the correct answer to proceed to the second of seven pages)

  1. Brain naturetic peptide (BNP)
  2. Chest x-ray
  3. Echocardiogram
  4. Electrocardiogram
  5. All of the above

Cite as: Loftsgard T. January 2018 critical care case of the month. Southwest J Pulm Crit Care. 2018;16(1):1-7. doi: https://doi.org/10.13175/swjpcc155-17 PDF

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