What’s Your Diagnosis? Right Heart Failure in the ED

Welcome to this month’s What’s Your Diagnosis Challenge!

But before we begin, check to see if you got the previous case on A Practice-Based Approach to Emergency Department Evaluation and Management of Patients With Postacute Sequelae after COVID-19 Infection: Long COVID correct.

Case Presentation: Emergency Department Management of Patients With Right Heart Failure

A 40-year-old woman presents with dyspnea, tachycardia, and hemoptysis…

  • Her vital signs are: temperature, 36.9°C; heart rate, 125 beats/min; blood pressure, 120/65 mm Hg; respiratory rate, 24 breaths/min; and oxygen saturation, 94%.
  • She takes estrogen-containing medications, and reports that she recently had a cross-continental airplane flight.
  • As you place initial orders, you consider whether transthoracic echocardiography would aid in her evaluation and management…

Case Conclusion

After CT confirmation of a diagnosis of pulmonary embolism, you performed a bedside TTE and diagnosed RVD based on an increased RV/LV ratio. You recognized the need for hospital admission due to her high risk for hemodynamic collapse, and you consulted your hospital pulmonary embolism response team for the consideration of advanced therapies. 

Click to review this Emergency Medicine Practice Issue, PTSD Symptoms

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Last Updated on April 10, 2024

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