Home > build your skills > crit-cases

Crit-Cases

A 58 year old man presents to the emergency department of a peripheral hospital with severe central chest pain associated with a brief syncope, vomiting and excruciating pain radiating to his neck and throat. He is grey and sweaty. His initial observations demonstrate a blood pressure of 150/100, HR 110 Sats 97% and respiratory rate 28.

Answer the following questions

Question 1
Question 2
Question 3
Question 4
Question 5

Outline the features of this ECG

Related Media:

Figure 1

List the features of this CXR. What is the most likely diagnosis? List 5 other xray features that, if present, would support this diagnosis.

Related Media:

Figure 2 - CXR

Describe the abnormality. List 3 other investigations that could positively identify this pathology.

Related Media:

Figure 3

List what management you would institute. What are the indications for surgery?

Prior to transfer the patient deteriorates to the point of respiratory arrest and is intubated. The following tests are performed. (Figure 4 - ECHO 1, Figure 5 - ECHO 2, Figure 6 - CXR 2, Figure 7 - ECG 2). List the abnormalities. What complication has occurred?