April 2025 Critical Care Case of the Month: Being Decisive During a Difficult Treatment Dilemma

By: VonEssen SG

Abstract:

No abstract available. Article truncated after 150 words.

History of Present Illness

A 71-year-old woman was seen in the emergency department with acute onset of shortness of breath. The patient was well until 3 days prior to admission when she developed pain and swelling in her right calf and ankle. She self-treated with ibuprofen and elevation. She was improving until the afternoon of admission she developed fatigue, dyspnea on exertion, and shortness of breath and came to the emergency department.

Past Medical History

• Partial adrenal insufficiency after resection of pituitary tumor in 1992
• Growth hormone deficiency, treated with augmentation therapy
• Hypothyroidism due to pituitary tumor and Hashimoto’s thyroiditis
• Gastroesophageal reflux disease
• Prediabetic
• Hypertension
• Iron deficiency, treated with daily iron
• Colon polyps (adenomas)
• Gluteal tendinopathy, right hip
• COVID-19 a month prior to admission with minimal symptoms

Surgical History

• Appendectomy at age 16
• Resection of pituitary macroadenoma at age 38
• Operations for herniated lumbar disks at age 47, 49 and …

URL: https://www.swjpcc.com/critical-care/2025/4/1/april-2025-critical-care-case-of-the-month-being-decisive-du.html