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Poster Presentations
Author(s) -
Betty Chan,
Angela Chiew,
Sarah Grainger,
Colin Page,
Ahmed Mostafa,
Michael Roberts,
Nicholas Buckley,
Geoffrey Isbister
Publication year - 2018
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12962
Subject(s) - medicine , family medicine
Amar Satyam, Sohil Pothiawala Singapore General Hospital Introduction: Hyperventilation syndrome is a relatively common emergency department (ED) presentation in which minute ventilation exceeds metabolic demands. It is associated with a wide range of symptoms without a clear organic precipitant. Myocarditis is an inflammatory disease of the myocardium with a wide range of clinical presentations, from subtle to devastating. It is caused by a wide variety of infectious organisms, autoimmune disorders, and exogenous agents. Case report: A 37 year old Egyptian lady who was 12 weeks pregnant presented to the ED with sudden onset of hyperventilation and chest discomfort. She also complained of numbness in the limbs but denied any other complaints. Clinically, she appeared well and her vitals were stable. Examination of heart and lungs was normal. ECG show normal sinus rhythm and ABG showed signs of hyperventilation (PH 7.54, PCO2 23mmHg, HCO3 20mmol/L and SaO2 99%). Chest xray was normal and bedside Echo did not show evidence of myocardial dysfunction, valvular abnormalities or massive pulmonary embolism. Troponin T was 426ng/L (normal < 30ng/L). Discussion: Diagnosing myocarditis is challenging in view of its varied presentations. There is no definite clinical feature that is diagnostic of myocarditis. It is typically seen in patients around age of 20–50 years and the variability in presentation reflects the variability in histological disease severity, etiology, and disease stage at presentation. Many cases go undetected because they are subclinical or present with nonspecific signs. Patients of myocarditis usually present with mild symptoms of chest pain, fever, sweats, chills, and dyspnea secondary to heart failure. This is a rare case where patient presented with shortness of breath which was not secondary to heart failure but only showed signs of hyperventilation of clinical examination and ABG. Conclusion: Emergency physicians treat young patients who present with shortness of breath secondary to hyperventilation/psychogenic dyspnoea. A high degree of suspicion is needed to diagnose myocarditis which can occasionally present with atypical symptom like hyperventilation. Paroxysmal supraventricular tachycardia in adult tuberous sclerosis complex: report of one case