Cardiology Case Report: Shortness of Breath Plus Erythrocytosis
This cardiology case report from Brady Pregerson, MD, features a woman in her 50s presenting with 3 days of body swelling and dyspnea. Check out the EKG and see if you can determine the correct diagnosis!
History:
A woman in her early-50’s presents to the hospital with 3 days of body swelling and dyspnea. She is on Lasix but does not know why. She denies any chest pain, fever, cough or other complaints.
Exam:
Vital signs are normal except for a pulse ox of 84% on room are and a respiratory rate of 24. BP is 112/77. Physical exam is otherwise normal except for swelling of both legs up to the hips. There are no rales or wheezes but slightly asymmetric breath sounds
An ECG is done:
Computer Read: NSR at 86, marked RAD, low voltage, RBBB
Credit: Brady Pregerson, MD
Other Initial Diagnostic Testing:
- CBC: Hb =19.3, Plt = 127, WBC = 16
- Chem-7: normal
- Cardiac: BNP: 855, trop 23
- Imaging: CXR appears clear
What is the most cause of EKG findings and erythrocytosis in this patient?
