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