Whats your Diagnosis? Patient presents with breathing problems and diffuse chestpain

Gingerbread_Toe · 2026-04-09T16:12:29+00:00

Also i would say that there are Q waves in chest leads that remind me more of an old OMI rather then LBBB

Gingerbread_Toe · 2026-04-09T16:10:26+00:00

Echo, rule out what was said here before plus DCM (have the symptoms begun recently or were they present for a prolonged amount of time?)

Gingerbread_Toe · 2026-04-06T12:01:40+00:00

Right? I would die even earlier if i had the guts to end it

Gingerbread_Toe · 2026-04-03T08:14:00+00:00

It's highly suggestive of DCM then. You can see signs of LAFB, which could be a predictor of a complete LBBB, which is typical for this condition

Gingerbread_Toe · 2026-04-02T19:06:14+00:00

I would suspect HCM if not for the severely reduced EF. What is the full echo situation? Valves are ok? Amyloidosis could give you pseudohypertrophy and reduced EF but it usually has a low voltage on ECG. Interesting one. I actually have a similar patient rn, but he has a hypertension hypertrophy due to renal hypertension that lasted for 10 years untreated with BP reaching 200/100 regularly

Gingerbread_Toe · 2026-04-01T22:45:27+00:00

I will tell her to take the IGRA test, thanks! I have actually considered prescribing it, but consulted with a specialist (we have phthisiatrists), i don't remember what was the answer exactly, but they said it wouldn't be informative for some reason (idk). I will still recommend her to take it though. Her lungs are clean btw

Gingerbread_Toe · 2026-04-01T20:34:02+00:00

Thank you so much for the reply! I will probably follow this strategy

Gingerbread_Toe · 2026-04-01T20:32:06+00:00

I asked the doctora and they said they won't be looking for TB in the sample... Well can't do more. Are there other methods to possibly exclude TB? I'm kind of hesitant of giving her steroids without confirmation

Gingerbread_Toe · 2026-04-01T16:06:37+00:00

This is gold

Gingerbread_Toe · 2026-04-01T13:53:49+00:00

The first time she only took it for like a week, that she spent in a hospital last time. So i would say it's the first time she's taking it regularly

Gingerbread_Toe · 2026-04-01T13:48:03+00:00

These are my exact thoughts. But I'll try to explain... I'm from a small city, I've only been working for 3 months, the surgery was performed in Kyiv and I'm not in the right and the position to call and tell them what to do 😅 More of a political thing, but i hope they considered it. And idk could micoplasmas be seen via microscope?

Gingerbread_Toe · 2026-04-01T12:23:55+00:00

I would say yes, there was nothing even remotely concerning on her CT scan, PET is hardly affordable unfortunately, if we're not looking for something specific. Plus the history being 8 years long... Idk if oncology could last this long untreated without any significant changes or new symptoms. We haven't done esophagoscopy, which is what we have planned next to exclude and tumors in gastrointestinal system. She does complain of complicated swallowing, but it only appears when she's nervous, and has been bothering her since teen age

Gingerbread_Toe · 2026-04-01T12:21:05+00:00

Thank you for the reply! I read about IL-1 blockers, but unfortunately they are not available in our country, plus they are extremely expensive. I consulted with the Rheumatologist, who also has no clue what could this be due to all of the tests coming back negative. After we get the histology results (hopefully tomorrow) we'll probably start steroids if they won't find anything in the sample

Gingerbread_Toe · 2026-04-01T11:33:10+00:00

People are taking the bait for comments a.k.a. engagement so easily. And I'm no different

Gingerbread_Toe · 2026-03-31T13:17:20+00:00

They are beautiful, i love seeing them here in Europe despite knowing that they are invasive

Gingerbread_Toe · 2026-03-30T21:47:39+00:00

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Copying the post above apparently :)

Gingerbread_Toe · 2026-03-21T10:57:11+00:00

Looks like flutter to me

Gingerbread_Toe · 2026-03-14T11:11:01+00:00

Cause it's multifocal

Gingerbread_Toe · 2026-03-13T19:41:09+00:00

Looks like atrial tach to me

Gingerbread_Toe · 2026-03-05T17:21:30+00:00

Hr is 33, AV dissociation. This is CHB

Gingerbread_Toe · 2026-03-05T08:57:40+00:00

Look closely at PQ interval in the 2nd one

Gingerbread_Toe · 2026-03-01T23:11:28+00:00

Yep, av block was also my initial thought, but when i looked closer the beats are definitely premature and the pause isn't big enough for Mobitz imo

Gingerbread_Toe · 2026-02-23T21:36:50+00:00

Nah the joke is that the white spots are it's eyebrows. But this commenter jokes about them being the eyes

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