Recently we were referred a female 67 yrs short stature with sudden onset history of breathlessness post CT contrast abdomen and chest.she was breathing at rate of 50 per minute and her saturation was 78% on air.she was out on bipap support after high concentration oxygen and nebulized bronchodilators failed to improve her condition.
she did not have any past history except hypertension for which she was on amlodipine 5 mg once a day.she underwent CT scan to rule out metastasis as she was now diagnosed to have carcinoma rectum.
her CT scan had shown multiple lung and liver Mets.u can see the x ray chest attached how it fails to show the findings.
we also did a 2 d echo which showed global hypokinesia and severe lv dysfunction with oderate MR and TR ,high PAH.
we gave her high flow nasal cannula support as she was not comfortable on bipap.
she recovered well at the end and discharged in six days.