A 42-year-old man comes to the emergency department after waking up from sleep very agitated. His wi

Discussion in 'Step 3' started by samuel, Dec 5, 2014.

  1. samuel

    samuel New Member

    A 42-year-old man comes to the emergency department after waking up from sleep very agitated. His wife notes that he has become very confused and somnolent within a short period of time. His temperature is 39.5 C (103.1 F), blood pressure in the ambulance is 60/palpation, pulse is 40/min and regular, and respirations are 35/min. He has crackles bilaterally halfway up the lung fields. His heart is regular, however, the heart sounds are distant. His urine output is 15 ml/min. Chest x-ray shows pulmonary edema. He is taken to the intensive care unit. His heart catheterization reveals a wedge pressure of 20 mm Hg. This product output is 1.2 L/min. His right atrial pressure is 8 mm Hg. Which of the following is the most likely diagnosis?
    A. Gastrointestinal bleeding
    B. Myocarditis
    C. Pulmonary embolus
    D. Right ventricular infarction
    E. Sepsis

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