72 YO F w/ PMH significant for HTN, COPD, asthma, borderline DM
presents c/o dyspnea on exertion over the past several months, worse
in the last week. In ED, oxygen sat 98% on RA. Previous heavy tobacco
use, now discontinued. Denies cough, CP, SOB, LE
swelling, f/c/n/v/d, abd pain, dysuria. No recent sick ctx/travel hx.
REVIEW OF SYSTEMS
CONSTITUTIONAL: (-) fever, (-) chills,
CARDIOVASCULAR: (-) chest pain, (-) palpitations,
RESPIRATORY: (-) cough, (+) SOB exertion, (-) SOB rest,
GASTROINTESTINAL: (-) pain, (-) nausea, (-) vomiting
MUSCULOSKELETAL: (-) back pain, (-) joint pain, (-) neck pain, (-) swelling.
INTEGUMENTARY: (-) abrasion(s), (-) rash.
VS - T: 97F BP: 137/59 HR:75 RR:18 Oxygen: 98% RA
CONSTITUTIONAL: The patient is alert and in no apparent distress. Appears WDWN.
CARDIOVASCULAR: Regular rate and rhythm, heart sounds normal, no
gallops, rubs or murmurs, no edema present.
RESPIRATORY: Breath sounds clear, no distress present, no wheezing
rales, rhonchi or tachypnea. Normal rate and effort.
GI/ABDOMEN: Soft, non-tender, no organomegly, no pulsatile mass.
Normal bowel sounds.
MUSCULOSKELETAL/EXTREMITES: Non-tender, normal ROM, no pedal edema or
calf tenderness. NVT intact.
INTEGUMENTARY: Color normal for race, warm and dry, no rash.
WBC - 5.47
Trop - <0.02
CK - 80
CKMB - 2.0
EKG - NSR@74bpm, nml axis, +PVCs, no acute ST changes
- What do you see in the image below?
- What is the minimum numbers of views necessary to confirm your diagnosis?
- For the pathologic finding in this image, what is the minimal threshold for detecion by U/S?
- Pericardial effusion
- A minimum of 2 views is necessary to confirm pericardial effusion on US
- 50 mL is the minimum threshold to see pericardial effusion on US