Case Report: Fatigue Following a Diverticular Bleed

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Check out our latest case report from Brady Pregerson, MD, which features a man in his 90s presenting to the ED with fatigue similar to what he had during a diverticular bleed less than 2 weeks prior.

Case Report: A man in his 90’s presents to the emergency department for fatigue similar to what he had a diverticular bleed a week and a half ago. At that time he required a transfusion of 4 units of blood. He denies any chest pain or shortness of breath but his pulse ox was noted to be low at 85% at home. He states his baseline is about 91-92%. He denies any bleeding, dark stool, or other complaints.

Exam: Vital signs are normal except for a pulse of 97 and a pulse ox of 85% on room air. Exam is notable for clear lungs, hypoxia and symmetric bilateral pitting leg edema. His chest x-ray is read out as normal. His blood work shows a normal CBC, metabolic panel, and cardiac enzymes.

An EKG is done:

EKG

What is the most likely primary diagnosis?

A) CHF

B) Pulmonary Embolism

C) Acute Coronary Syndrome

D) Anxiety



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