SAQ 486 – Cardiology – shock with subxiphoid ultrasound image

A 70-year-old man presents with shortness of breath and dizziness. He has ischaemic heart disease, atrial fibrillation and hypercholesterolaemia, and takes metoprolol, rivaroxaban and atorvastatin. His observations and subxiphoid ultrasound image are shown below.

Observation	Result
Heart rate	100/min, atrial fibrillation
Blood pressure	90/50 mmHg
Temperature	37.8 C
SpO2	96% on 8 L oxygen via Hudson mask

Label the subxiphoid ultrasound image.

(Marked out of 4.0)

/ 4

List six (6) categories of differential diagnosis for the underlying cause and give two (2) examples for each.

(Marked out of 18.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Category</th> <th>Examples</th> </tr> </thead> <tbody> <tr> <td>1.</td> <td></td> </tr> <tr> <td>2.</td> <td></td> </tr> <tr> <td>3.</td> <td></td> </tr> <tr> <td>4.</td> <td></td> </tr> <tr> <td>5.</td> <td></td> </tr> <tr> <td>6.</td> <td></td> </tr> </tbody> </table> <p>

/ 18

What are the two (2) most likely causes in this patient?

(Marked out of 2.0)

/ 2

State the one (1) management step most likely to relieve his symptoms.

(Marked out of 1.0)

/ 1

State three (3) pros and three (3) cons of performing this management step in the ED rather than on the ward.

(Marked out of 6.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Pros</th> <th>Cons</th> </tr> </thead> <tbody> <tr> <td>1.</td> <td></td> </tr> <tr> <td>2.</td> <td></td> </tr> <tr> <td>3.</td> <td></td> </tr> </tbody> </table> <p>

/ 6

Total Score: 0 / 31

Percentage: 0%