- Nov 16, 2005
- Reaction score
55M admitted from ED with AMS and BP 225/125. Noncompliant with HTN and DM2 therapy. BNP is 30k, TTE find EF of 45% with severe diastolic dysfxn and moderate MR, inferior infarct with segmental wall motion abnormality. Hep C, cirrhosis, CKD with Cr2.5. Later dx'd with multiple cerebral and cerebellar infarcts, but also a penile infarct. Four days later, he's septic, and urology wants to excise the necrotic tissue. Pt scheduled for TEE to look for clot or vegetations, but cardiology cancels because they decide he needs surgery first. Urologist needs to know if we're going or not because she has to get to clinic. Send him back upstairs for the echo or do the case?