Clinical Conference 5/18/07. 34 y.o. with h/o HTN, presented to Christ ED after LOC while playing basketball. Upon arrival....unresponsive…and found to.

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Presentation transcript:

Clinical Conference 5/18/07

34 y.o. with h/o HTN, presented to Christ ED after LOC while playing basketball. Upon arrival....unresponsive…and found to have…

After he woke up… ROS: denied CP, denied drug use, no SOB, no LH, no Dizzines, no orthopnea, no PND. No polyuria Meds: prescribed HCTZ, but reports has not taken recently PMHx: HTN; no CAD, no HL, no DM FH: no early CAD, no SCD SH: no tob, occ EtOH, no IVDU

Physical Exam: BP 145/70, P 90, T 98.6, Pulse ox 96% RA GEN: groggy, healthy appearing Neck: supple, no JVD, nl carotid volumes and upstroke CV: RRR, nl s1, s2, no s3, +s4; no m/r/g; quiet precordium, non-displaced PMI Lungs: CTAB anteriorly GI: soft, NT, ND Ext: no edema, 2+ distal pulses

EKG after cardioversion

Right sided EKG

Posterior EKG

Labs: Na 137 K 2.1 Cl 100 CO2 20 BUN 13 Cr 1.6 Mg 2.1 Ca 8.7 Phos 2.4 WBC 8 Hgb 14.2 HCT 44.1 PLT 266 INR 1.0 CK 173 CK-MB 2.0 Trop 0.09 BNP 150 Next set of cardiac enzymes 4/16/07 at 1500 CK 491 CK-MB 28.5 Trop /15/07 at 1735 What to do next?