Stuck with a rock in a hard (to get) place
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A 77 yo female presented with chest pain and dyspnoea over a 3-week period. Initially treated for a chest infection but without improvement resulting in her being less mobile and mostly chair bound.
She reported pain behind her left thigh and a sudden onset shortness of breath associated with pressure like chest pain whilst in hospital. There was no syncope or presyncope. On examination there was lymphoedema and her left leg was more swollen than the right. ECG showed a sinus tachycardia 112bpm, BP 100/78mmHg with T-wave inversion in V1-V4 and a raised Troponin of 445ng/l with a normal BNP 36pg/ml. She had a previous DVT in her left leg a decade before with no obvious provoking factor identified.
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Stuck with a rock in a hard (to get) place
Authors
Ramcharitar S.1, Foley P.1, Chandrasekaran B.1- Great Western Hospital, Swindon, UNITED KINGDOM
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