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.