JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
ECG CASE OF THE MONTH
Cyanotic Congenital Heart Disease and Diarrhea in a 42-Year-Old Man
D. Luke Glancy, MD, Chun W. Tan, MD, and Frederick R. Helmcke, MD
A 42-year-old Latin-American man, cyanotic from birth, was admitted to the hospital with diarrhea for two weeks, accompanied by weakness, dyspnea, and fatigue. Exam revealed decreased skin turgor, cyanosis, clubbing of fingers and toes, and prominent systolic and diastolic heart murmurs heard widely over the precordium. Pulse was 90 beats/minute and irregular. Blood pressure was 106/70 mmHg. Neck veins were normal, and upper and lower extremity pulses were full. Oxygen saturation by pulse oximeter was 46%with the patient breathing air. An electrocardiogramwas recorded (Figure1).
Figure 1: Electrocardiogram in a 42-year-old man with cyanosis, dyspnea, and diarrhea. See text for explication.
What is your diagnosis? Explication is on p. 29 .
28 J La State Med Soc VOL 170 JANUARY/FEBRUARY 2018
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