Figure 1: ECG of patient showing sinus tachycardia
The patient was promptly transferred to the Intensive Care Unit (ICU),
where oxygen supplementation was initiated at a rate of 10 liters per
minute via a face mask. At this point, the patient’s blood pressure was
measured at 180/100 mmHg, pulse rate at 132 beats per minute,
respiratory rate at 35 breaths per minute, oxygen saturation at 77%,
temperature at 96.6 degrees Fahrenheit, and blood glucose level at 127
mg/dL.
Further investigations revealed arterial blood gas(ABG) findings
consistent with respiratory alkalosis and hypoxemia. A chest X-ray
demonstrated diffuse bilateral infiltrates suggestive of pulmonary
edema. Electrocardiography (ECG) showed only sinus tachycardia.
Bedside lung scanning revealed normal lung sliding with multiple kerley
B lines. Bedside echocardiography screening ruled out structural cardiac
abnormalities or evidence of cardiogenic pulmonary edema. Additionally,
bedside venous Doppler of bilateral lower limbs was performed to exclude
venous thromboembolism. Laboratory investigations, including complete
blood count, renal function tests, electrolytes, bleeding time, and
clotting time, were all within normal limits, except for a total white
blood cell count of 16,900/cumm with 89% neutrophils. Slight elevations
in serum glutamic pyruvic transaminase (SGPT) at 64 IU/L and serum
glutamic oxaloacetic transaminase (SGOT) at 69 IU/L were noted, but they
were deemed insignificant. Furthermore, the D-dimer test yielded
negative results.