ECG

Độc lên tim do dùng thuốc

Độc lên tim do dùng thuốc

Section I: Case presentation Bệnh nhân nữ 66 tuổi vào cấp cứu vì khó thở nặng và khó thở khi nằm đã vài ngày. bà không đau ngực, đau bụng, buồn nôn hay nôn. bà có đau toàn bộ đầu từng cơn. bàcóho khan, không sốt. Bà có tiền sử suy tim sung huyết (CHF), EF 10–20%, THA, tiểu đường type II, COPD và đã cắt túi mật. thuốc đang dùng gồm aspirin, nitroglycerin, furosemide, digoxin, metoprolol, pantoprazole, citalopram, albuterol/ipratropium, và fluticasone/salmeterol. bà dị ứng với clarithromycin và azithromycin. bà có hút thuốc lá Khám bệnh nhân, dấu hiệu sinh tồn: nhiệt độ 36.1˚C , mạch 60, thở 24l/p, huyết áp 154/82 mmHg, và spO2 98%. bệnh nhân không vã mồ hôi. kết mạc không nhợt. tĩnh mạch cổ nổi. phổi có ralé 2 đáy phổi và tiếng cò cử khi thở ra. khám tim nhịp đều, tiếng thổi toàn tâm thu III/VI lan tới nách. bụng mềm, ấn không đau, không sờ thấy khối hay có mạch đập, mạch 2 chân như nhau và có phù ngoại vi Xét nghiệm: BUN 63 mg/dL, creatinine 2.4 mg/dL, hct 30.1%, BNP…

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Cuộc đời thì ngắn, mà nghề thì miên man;cơn bệnh phập phù;kinh nghiệm hiểm nguy, còn quyết định thì thật khó.Người thầy thuốc không phải chỉ chuẩn bị để tự mình làm đúng, mà còn khiến cho bệnh nhân, người đi theo và các yếu tố xung quanh hợp tác hài…

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_WidgetManager._RegisterWidget('_ContactFormView', new _WidgetInfo('ContactForm0000001', 'sec_Theme_Hidden', document.getElementById('ContactForm0000001'), {'contactFormMessageSendingMsg': '\u0110ang g\u1eedi...', 'contactFormMessageSentMsg': 'Th\u01b0 c\u1ee7a b\u1ea1n \u0111\xe3 \u0111\u01b0\u1ee3c g\u1eedi.', 'contactFormMessageNotSentMsg': 'Kh\xf4ng th\u1ec3 g\u1eedi th\u01b0.\xa0Vui l\xf2ng\xa0th\u1eed l\u1ea1i sau.', 'contactFormInvalidEmailMsg': 'C\u1ea7n nh\u1eadp \u0111\u1ecba ch\u1ec9 email h\u1ee3p l\u1ec7.', 'contactFormEmptyMessageMsg': 'Tr\u01b0\u1eddng th\u01b0 kh\xf4ng th\u1ec3 \u0111\u1ec3 tr\u1ed1ng.', 'title': 'Bi\u1ec3u m\u1eabu li\xean h\u1ec7', 'blogId': '6712670173064621179', 'contactFormNameMsg': 'T\xean', 'contactFormEmailMsg': 'Email', 'contactFormMessageMsg': 'Th\xf4ng b\xe1o', 'contactFormSendMsg': 'G\u1eedi', 'contactFormToken': 'AOuZoY7inkp0mKLvTUnhwVhD9xLfUdSkCw:1732401677383', 'submitUrl': 'https://www.blogger.com/contact-form.do'}, 'displayModeFull'));
_WidgetManager._RegisterWidget('_LinkListView', new _WidgetInfo('LinkList0000002', 'sec_Addon_Widgets', document.getElementById('LinkList0000002'), {}, 'displayModeFull'));
_WidgetManager._RegisterWidget('_LinkListView', new _WidgetInfo('LinkList7', 'sec_Addon_Widgets', document.getElementById('LinkList7'), {}, 'displayModeFull'));
_WidgetManager._RegisterWidget('_HTMLView', new _WidgetInfo('HTML22', 'sec_Addon_Widgets', document.getElementById('HTML22'), {}, 'displayModeFull'));
_WidgetManager._RegisterWidget('_ImageView', new _WidgetInfo('Image5', 'sec_Addon_Widgets', document.getElementById('Image5'), {'resize': false}, 'displayModeFull'));
</script>
</body>