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 Best of Five 2.210

 

   

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BOF: 2.210

A 60-year-old female presents with sudden onset of breathlessness, pleuritic chest pain and syncope. She gives history of recently returning to the UK from a holiday in Australia.  There are no past illnesses of note and she is not on any medication .

On examination she looks pale, has a tachycardia of 120 beats per minute BP 80/50 JVP elevated predominant V wave, there is a triple rhythm with a loud second sound on auscultation of the heart. There is a pan systolic murmur at the left sternal edge; a pleural rub is heard at the left base of the lung

In this patient which of the following would you use as therapy?

a)      Thrombolysis

b)      Intravenous diuresis

c)      Inotropes

d)      Intravenous fluids and vasoconstrictors

e)      Intra-aortic balloon counterpulsation

 

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