A 48 year old woman is brought in by ambulance with SOB Palpitations 1 week of fever, cough, diarrhea and anorexia On examination HR 200/min, irregularly irregular BP 109/70 RR 40/min saturations 94% on room air temperature 37.5 This is her ECG What is your differential diagnosis? Differential diagnosis [...]
Case and images Marta Malkiewicz A 30 year old man from Indonesia who has been in Australia for 7 years presents with shortness of breath and cough. History Shortness of breath for 1 week Occasional central chest pain not pleuritic in nature Productive cough , yellow sputum, no haemoptysis 5 [...]
Images Heimerich Bisterbosch A 40 year old man presents with worsening abdominal distension on a background of alcoholic cirrhosis. On examination: Cachectic Speaking in short sentences Tense abdominal distention from ascites Absent breath sound right chest Saturating 92% on 2l of oxygen BP 107/70 HR 90/min This is his chest [...]
Case and images James Dent A 44F presents with chest pain for 20 mins, central chest reflux/burning sensation. Onset on leaning forward to open drawer. Now just in left shoulder. Then tingling to bilateral hands, feet and generalised and spasming of hands. Recently well OE: eyes closed, SaO2 100% on [...]
Case and images Sarah Vaughan Discussion Genevieve Carbonatto A 55 year old man presents to the ED with 5 days of loin to groin pain and microscopic haematuria. He was started on nitrofurantoin as an outpatient for a possible UTI. A point of care renal ultrasound is performed This is [...]
Images Daniel Loui Text Genevieve Carbonatto A 60 year old lady presents with recurrent syncopes associated with frequent falls. 2 weeks prior to presentation she had a fall on her right buttock causing right hip pain. Subsequently she developed a small heamatoma over her right buttock and a larger right [...]
A 14 year old boy presents to ED with throat and neck pain after persistent vomiting. He states he vomited > 30 times over the previous 8 hours. On examination: oxygen saturation 98% on RA, BP 128/89, HR 66/min. No obvious crepitaions to the neck. A chest Xray was ordered [...]
Case and images courtesy of Dr Micky Fiorentino (ultrasound under supervision of Dr James Dent) Triage at 1pm: 46F, representation with recurrent RUQ pain. Known gallstones. Representing with further pain, yellow skin colour and pale stool and dark urine. O/E Minimally tender RUQ, Murphy’s negative Jaundiced Initial blood tests: Hb [...]
A 72 year old lady presents to the Emergency Department with syncope. A point of care ECHO is performed. What is the structure in the right atrium? https://www.criticalcare-sonography.com/wp-content/uploads/2023/05/Produce_11.mp4 This is a Eustachian valve. The differential diagnosis would be a tumour, a thrombus or a vegetation. In the [...]
Dr Chris Harrington (FACEM) presents 2 cases for this month. Both demonstrate the importance of ECHO in the context of the deteriorating patient with heart failure. A 48F is referred to the Emergency department by her cardiologist with exacerbation of right heart failure and rapid AF PHx aortic valve repair [...]