AAAAA
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Question 1. 67 year-old male post-op 3 days was walking in the hallway and collapsed and died. He had cholecystectomy and was ready to be discharged.
What is the diagnosis?
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(real case I saw as a third year medical student)
Question 2. 68 year-old female with chest pain, underwent coronary angiography and discharged home.
Patient died suddenly at home around 2 hours after going to bed at home.
What is the diagnosis?
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| abhi01
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can't say much about the 1st, but
looks like cholesterol embolization for the 2nd
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| AAAAA
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abhi01,
absolutely right.
P.E. P.E. pulmonary emboli.
Both died from pulmonary emboli.
The second one died from cholesterol emboli to the lung.
"Do no harm as a healer !"
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| AAAAA
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abhi01,
absolutely right.
P.E. P.E. pulmonary emboli.
Both died from pulmonary emboli.
The second one died from cholesterol emboli to the lung.
"Do no harm as a healer !"
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| jvo_md
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Q1- Maybe...Cerebral Emboly
Q2- Need more clinical findings...SOB, ECG findings...Some more Signs and Symp...
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| AAAAA
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I understand we need more information but in real life patients died and it was too late to ask for symptoms and labs.
It is so important we must remember PE can occur in any elderly patient post-operatively and underwent any invasive procedure such as cardiac cathetherization.
Later on inlife, when you start your practice, you can not order all kind of lab and you don't have time to ask all kind of questions.
So welcome to real medicine and I present to all of you in a very humble way to tell you as it is how patient died !
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| AAAAA
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Dr. jvo_MD,
Autopsy confirmed pulmonary embolism in both cases.
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| guayoman
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Yeah but pulmonary emboli where made of cholesterol both times? I thought fat emboli where from orthopedic surgery/trauma.
Could this emboli have been from CID or other coagulation disorder?
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| AAAAA
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The first case is not fat emboli but probably atherosclerotic plaque secondary to immobilization.
The second case is probably cholesterol emboli.
The 1st case was presented on Friday afternoon lecture.
The 2nd case is the mother of my gf's close friend who died after angiography and had autopsy done
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| guayoman
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One more Q and I'm done:
shouldn't pulmonary embolism be massive to cause death?
I understand cerebral embolism or coronary embolism causing sudden death...but pulmonary embolism has me scratching my pretty little head.
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