Physical Exam Findings: She was fully alert and oriented to who she was, place, time, and reason. She did not display any signs of acute distress upon examination and was saturating well on 6L of oxygen provided through NC. She displayed normal breath sounds without wheezing, rales but she did display an elevated breathing rate. During the examination, her heart rate was within normal limits, displaying a regular rhythm, S1/S2 without murmur, and absence of gallop or rub. Patient did not display any pitting edema and had palpable pedal pulses. Patient demonstrated right sided weakness as well. Lab Findings: Patient’s CBC and CMP displayed WBC 13.4, Hb 10.7, Glucose 257, BUN 27, Cr 1.35. Patient’s roponin was also noted to have elevated from 0.05>0.87 and BNP had increased from 1000>1544. Diagnostic Test Findings: Chest x-ray showed bilateral pulmonary edema and small effusions. An echocardiogram showed EF 40%. Apico-antero-septal akinesis, moderate to severe AS, LA mild dilation, and an RVSP of 46. V/Q scan was negative for pulmonary embolism.
Final Diagnosis: Acute hypoxic respiratory failure due to acute CHF exacerbation.
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