March 2018 critical care case of the month

Abstract

No abstract available. Article truncated after 150 words. Chief Complaints • Shortness of breath • Worsening bilateral LE edema History of Present Illness A 53-year-old man with history of multiple myeloma and congestive heart failure presented to the emergency department with complaints of worsening shortness of breath and bilateral lower extremity edema for last 24 hours. In the last week, he has had dyspnea at rest as well as a productive cough with yellow sputum. He describes generalized malaise, loss of appetite, possible fever and notes new bilateral pitting edema below his knees. Per patient, he had flu-like symptoms one week ago and was treated empirically with oseltamivir. Past Medical History • Multiple myeloma-IgG kappa with calvarial and humeral metastases, ongoing treatment with cyclophosphamide, bortezomib and dexamethasone • Community acquired pneumonia 2016, treated with oral antibiotics Heart failure with echo 10/2017 showing moderate concentric left ventricular hypertrophy, left ventricular ejection fraction 63%, borderline left atrial and right atrial dilatation, diastolic dysfunction, right …

Keywords

• amyloidosis
• cardiac amyloidosis
• multiple myeloma
• diagnosis
• chest x-ray
• CT scan
• treatment
• right ventricular hypertrophy
• ultrasound
• electrocardiogram