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Ultrasound Corner |

Middle-Aged Woman With Shock

Siddharth Dugar, MD; Phani Kantamneni, MD; Charles R. Lane, MD; Ajit Moghekar, MD
Author and Funding Information

CORRESPONDENCE TO: Ajit Moghekar, MD, Deptartment of Critical Care, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave, L2, Cleveland, OH 44195


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(2):e45-e47. doi:10.1016/j.chest.2015.08.025
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Extract

A middle-aged woman with a medical history of COPD on 3 L of home oxygen, idiopathic thrombocytopenic purpura status postsplenectomy, and hypothyroidism presented to the ED with fever and change in mental status. On presentation, she was febrile (temperature 39.6°C), tachycardic (heart rate, 130-140 beats/min), and hypotensive (blood pressure, 89/57 mm Hg). Her respiratory rate was 24 to 26 breaths/min and oxygen saturation of 84% on room air, which improved to 95% on 40% Venti mask. Physical examination revealed a middle-aged woman who was unresponsive, moaning, and grunting. She had labored breathing with bilateral crackles. Cardiac examination revealed tachycardia with a collapsed jugular vein.

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