CASE #5

HISTORY:

The patient is 68 year old female with a history of CHF, HTN and atrial fib who presents with a chief complaint of feeling "weak and dizzy" after ingesting a handful of her "heart pills" 3 hours prior.

PHYSICAL EXAM

• General: Patient appears her stated age, with blue-tinted hair, resting quietly on a monitored bed.
• Vitals: P=48 BP= 90/60 RR= 24 T= 98.6
• Neck: No JVD
• Lungs: Crackles at bases bilat
• CV: Bradycardic, Irreg RR, no murmurs
• Ext: No cyanosis, thready periph pulses

DIAGNOSTIC STUDIES

• ECG: Rate of 40-50/min with 3:1 A-V block
• CXR: Cardiomegaly, no acute failure
• Lytes: Na=145 K=5.9 Cl=104 HCO3=24
• BUN/Cr: 46/2.2
• Glucose: 120

Toxin and Discussion References