Monday, June 28, 2010

Asymmetry (as opposed to a symmetry)

This image is from a 32 year old woman who presents with acute dyspnea about 2 weeks after an elective c-section. She has leg pain at the site indicated by the arrow. An EKG is shown below.

Challenge: Many things may be on the differential, but the most likely diagnosis is what?

First image shown under Creative Commons Attribution Share-Alike License. Second image shown under GNU Free Documentation License.


tree said...

DVT --> PE

Craig Chen said...

yes! sorry for the late reply
Asymmetry (as opposed to a symmetry)

This is deep vein thrombosis and presumably pulmonary embolism. Pregnancy and the post-pregnancy period greatly increase the risk of DVT and PE, and additional risk factors include C-section, premature birth, history of cardiac disease, and multiple births. The EKG shows sinus tachycardia, often seen with pulmonary embolism.

Sources: UpToDate; Wikipedia.