Hypertension In The High Seas

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Hypertension In The High Seas - Page #3

Lab Studies: None Other Studies: The patient's initial 12-lead electrocardiogram demonstrated first-degree atrioventricular block. His coronary calcium score was found to be 193 Angstrom Units, or 78% for his age group. He underwent coronary angiography which resulted in the placement of two drug-eluting stents in his right coronary artery and left anterior descending artery. Though he attempted to return to triathlons after stenting, he experienced a third bout of frank hemoptysis during the swimming event, and his oxygen saturation at the scene was 80%. Hospital admission following this episode included a chest radiograph with evidence of pulmonary edema. Echocardiogram demonstrated severe, concentric left ventricular hypertrophy, mild mitral regurgitation, and mildly abnormal diastolic filling dysfunction. He was not willing to consider abandoning his triathlon aspirations and requested further workup for risk stratification. This included an exercise cardiac catheterization Case Photo #1 , which did not demonstrate any evidence of micro-ischemia. Additionally, an underwater stress echocardiogram Case Photo #2 was obtained; the patient's systolic blood pressure rose to 345 mmHg accompanied by a 'gurgling sensation' in his chest. Consultations: Cardiology Pulmonology Anesthesiology Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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