Ultrasound for critical care physicians: really, at her age?

• Main Author: Wesselius LJ
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2014-05-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: patent foramen ovale; PFO; right to left shunt; hypoxia; echocardiography; cardiac ultrasound; Doppler flow; transthoracic; intracardiac shunt; orthodeoxia; platypnea
• Online Access: http://www.swjpcc.com/critical-care/2014/5/5/ultrasound-for-critical-care-physicians-really-at-her-age.html

No abstract available. Article truncated after first page. A 71 year old woman presented with dyspnea since late 2013 and denies a prior history of dyspnea. She had a cardiac pacemaker placed in 2008 for sick sinus syndrome. Her physical exam was unremarkable and her SpO2 was 96% on room air. However, it decreased to 84% with exercise. Chest x-ray and pulmonary function testing were unremarkable (a DLco was unable to be performed). A transthoracic echocardiogram was performed (Figure 1). Which of the following best explains the patient's dyspnea and hypoxia? 1. Cardiac tamponade; 2. Decreased cardiac contractility; 3. Intracardiac shunt; 4. Mitral insufficiency; 5. Ventilation perfusion mismatch from COPD ...