Trolling other forums for a cool case...

[J-Rad]

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Hey guys:
There was a unintendedly cool case posted on the DO forums:
http://forums.studentdoctor.net/showthread.php?t=651061

But they're a bunch of party poopers, and don't want to play. And I know the peds folks are much cooler and like to play 😉.

So if anyone's game go read. Try not to look past post 13 since I almost gave it away in #14.

I know nothing of the case but what's there, so it's kind of just a DDx case, but I think it's cool. Maybe we could change it around and say that the little blue alien Peds ED doc (you know who you are) down in Tideland had this teenage patient (?18) come in (She's from EBF Maine on vaca at da beach). WWSD?

 

[Stitch]

Hey guys:
There was a unintendedly cool case posted on the DO forums:
http://forums.studentdoctor.net/showthread.php?t=651061

But they're a bunch of party poopers, and don't want to play. And I know the peds folks are much cooler and like to play 😉.

So if anyone's game go read. Try not to look past post 13 since I almost gave it away in #14.

I know nothing of the case but what's there, so it's kind of just a DDx case, but I think it's cool. Maybe we could change it around and say that the little blue alien Peds ED doc (you know who you are) down in Tideland had this teenage patient (?18) come in (She's from EBF Maine on vaca at da beach). WWSD?

That's a great case, and one that has some cool learning points. I might could throw something together since I'm not quite so busy as a cards fellow. 😉

 

[J-Rad]

🙁*Crickets chirping*...Anyone?

 

[WhatUpDoc!]

Heterotaxy?

 

[J-Rad]

http://emedicine.medscape.com/article/896757-overview
http://emedicine.medscape.com/article/896865-overview
(See the mortality/morbidity sections in particular)

This is somewhat of the vagaries of making up the case, so despite the good thought, I think the likelihood of a heterotaxy growing up to 19 without having their chest cracked open is low (and believe me, if they've ever had their chest cracked open in childhood, it's pretty rare for anyone to get diagnosed with anxiety as cause of chest pain in the primary or emergency care-even when it is). This is a little more subtle since I think most heterotaxies are picked up a lot earlier in life. However, you are correct in noting that dextrocardia can have a strong association with the heterotaxies (~30% of heterotaxies will have dextrocardia and dextrocardia with a certain situs of the abdominal organs is associated with heterotaxies).
But since you had a good thought it might lead to some questions to ask in the history.