A 72-year-old woman presents with worsening abdominal distension and discomfort. During the examination, she exhibits significant dependent edema and an elevated JVP. Cardiac auscultation reveals a pansystolic murmur. The abdomen is distended and tender, with the presence of shifting dullness.
What is the SINGLE most probable diagnosis?
Whilst assessing a patient in the Emergency Department, you observe a diastolic murmur.
Which of the following is NOT a potential cause of a diastolic murmur?
A 45-year-old woman presents with recurrent episodes of central chest pain that radiate to her left arm. She has a history of angina and uses a GTN spray for relief. She reports that the pains have been occurring more frequently in the past few days and have been triggered by less exertion. Currently, she is not experiencing any pain, and her ECG shows normal sinus rhythm with no abnormalities in T wave or ST-segment.
What is the SINGLE most probable diagnosis?
A 48 year old female presents to the emergency department complaining of palpitations. She reports experiencing brief episodes of palpitations over the past week, which typically resolve on their own after 5-10 minutes. However, today’s episode has been ongoing for 30 minutes. The patient denies any chest pain or shortness of breath. The patient’s vital signs are as follows:
Blood pressure: 110/70 mmHg
Pulse: 120 bpm
Respiration rate: 17 bpm
Temperature: 36.5ºC
Oxygen saturations: 97% on room air
An electrocardiogram (ECG) is performed and reveals atrial fibrillation. What is the most appropriate initial management for this patient?
A 55-year-old woman comes in with severe chest pain in the center of her chest. Her ECG reveals the following findings:
ST elevation in leads I, II, aVF, and V6
Reciprocal ST depression in leads V1-V4 and aVR
Prominent tall R waves in leads V2-V3
Upright T waves in leads V2-V3
Based on these findings, which blood vessel is most likely affected in this case?
A 60-year-old woman comes in with severe, crushing chest pain that spreads to her left shoulder and jaw. The pain has improved after receiving GTN spray under the tongue and intravenous morphine.
What other medication should be recommended at this point?
A 45-year-old male smoker comes in with a severe episode of chest pain that spreads to his left arm and jaw. The pain lasted for about half an hour before being relieved by GTN spray and aspirin. A troponin test is done 12 hours later, which comes back positive. His ECG at the time of presentation reveals widespread ST depression.
What is the MOST LIKELY diagnosis in this case?
A 72-year-old woman presents with severe central chest pain. An ECG is performed, which shows ST elevation in the anterolateral leads. She was given aspirin and morphine upon arrival. Her observations are as follows: SaO2 99% on air, HR 89 bpm, and BP 149/87 mmHg. Upon discussion with the cardiology team, a decision is made to perform an urgent percutaneous coronary intervention (PCI).
Which of the following medications could you also consider administering to this patient?
A 72-year-old woman with a history of type II diabetes and hypertension presents with a history of central chest pain that lasted approximately 45 minutes. Her ECG showed T wave inversion in the lateral leads, but her pain settled, and ECG normalized following the administration of GTN spray and IV morphine. She was also given 325 mg of aspirin on arrival. A troponin test has been organized and admission arranged.
Which of the following medications should you also consider administering to this patient?
A 72-year-old woman with a history of type II diabetes and hypertension presents with central chest discomfort. Her ECG showed ST depression in the inferior leads, but her discomfort subsides, and ECG returns to normal after receiving GTN spray and IV morphine. She was also given 300 mg of aspirin in the ambulance en route to the hospital. Her vital signs are as follows: SaO2 99% on room air, HR 89 bpm, and BP 139/82 mmHg. A troponin test has been scheduled and she is scheduled for an urgent coronary angiography.
Which of the following medications should you also consider administering to this patient?