Cardiology Morning presentation 2 IM
Dr Ihab Suliman
MBBS, ECFMG, CBNC,MRCP,AB Card
22/6/2012
Case 1
• 59 years old saudi male came through ER with SOB class 3- 4, feeling unwell .
• He is DM , HTN , DLP.
• Recent CABG
Case 1 ECG A
• Low Limb Leads ECG ,NSR, Electrical elternanus ,Recent Anterior MI
Case 1 ECG B
CXR 14/6/2012
• Portable CXR of severe cardiomegally.
• There are important 3 differentials
• 1-Pericardial effusion
• 2-Multivalvualr lesions
• 3-severe DCM
• Inverted View CXR showing severe cardiomegally but clear lung fields
CXR 4/6/2012
• 2 weeks earlier CXR on discharge from cardiac surgery ward showing some cardiomegally and mild bilateral pleural effusions ,this is expected following CABG
Cardiac Enzymes within NL
PE
• Large Pericardial effusion mainly posterior
• CXR much less cardiomegally after pericardial drain , peg tail still inside
Case 2
• 25 years old known case of marfan’s syndrome came with SOB, and chest pain
• Severe Cardiomegally .
• In this cas there was Dilated Aorta root
• Plus severe DCM the patient had marfan syndrome
• Severe DCM Plus severe aorta dilatation plus dissection flap.
Case 3
• 62 years old male with Acute severe SOB.
• Known HTN
• Mild cardiomegally plus mild right hilar congestion
• Mild to moderate AR + MR + mild pericardal effusion
• Sclerotic aortic valve
• 78 yrs old male patient came with severe central chest pain increases with respiration
• Known diabetic and hypertensive with chronic kidney disease
• ECG of Hyperkalemia plus LVH characteristic finding in Renal failure patients