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Gladys' condition is unchanged the next
morning.
- Vital signs unchanged.
- Biox is 94% with pulse of 120.
- EKG indicates low voltage and sinus
tachycardia.
- Blood pressure is checked again and a
pulses paradox of 15 mm Hg is noted.
- A chest X-ray done that morning hangs
from her light. (Click here for a larger image.)
- The team decides to:
- Check sputum for AFB and
- Talk the family into paying for an
echocardiogram
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Gladys likely has tubercular pericarditis.
- Her echocardiogram showed a large
pericardial effusion with organizing constrictive pericarditis.
- Her HIV ELIZA was negative.
- Prednisone was added to her treatment
regimen.
- A cardiovascular surgical consult was
requested.
- Four days later the CV surgeon saw her
and decided to do an anterior pericardectomy, after two weeks of medical
treatment.
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Photo Courtesy of ECG Library |
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Steroids?
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