Patient with Pulmonary Embolism.
Patient with Pulmonary Embolism.
Imagine a patient with Pulmonary Embolism comes into your office with your selected condition or disorder. What elements in the patient history and physical exam would indicate the patient has the selected condition or disorder? Select two differential diagnoses that could be applied to this patient. How did you arrive at the two differential diagnoses? Include history and physical examination findings that would support each of the two alternative diagnoses.
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Takotsubo Cardiomyopathy initially appears an an acute life threatening disease process involving the cardiovascular system (Renko, Doyle & Sokoloski, 2019).
Takotsubo cardiomyopathy (TC) is an uncommon condition that mimics a heart attack and occurs after extreme and immense physical or emotional stress (Kalra et al., 2019). It also occurs in women far greater than men, as 89% of Takotsubo diagnoses are female (Kalra et al., 2019). TC also has a consistent finding of occurring mostly in post menopausal women (Renko, Doyle & Sokoloski, 2019). Takotsubo presents on an echocardiogram as left ventricular cardiomyopathy and is reversible (Kalra et al., 2019).
The origination is believed to be cardiotoxic in nature from a sudden surge in catecholamies, excess adrenergic stimulation like pheochromocytoma, intense coronary vasospasm, and some neurological emergencies (Kalra et al., 2019). Recognizable properties of TC is that the left ventricle shows hypokinesis of the mid and apical left ventricle, while the base remains unchanged or shows compensatory hypokinesis (Kalra et al., 2019). Even though TC is reversible, mortality for an acute onset of TC is actually the same as an Acute Coronary Syndrome patient (Renko, Doyle & Sokoloski, 2019).
Due to TC’s unique presentation mimicing an MI or ACS, this is a case of the risk of not doing tests being far greater to the patient and their life, than doing lab work and tests (Renko, Doyle & Sokoloski, 2019). So for this reason, a full cardiovascular workup is necessary (Renko, Doyle & Sokoloski, 2019).
The unique presentation of Takotsubo is the same as an acute myocardial infarction (MI), or Acute Coronary Sydrome (ACS) which would necessitate a MI and ACS workup (Renko, Doyle & Sokoloski, 2019). Labs and tests include EKG, troponins, cardiac enzyme, and echocardiogram (Kalra et al., 2019). TC will show positive 8.
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