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The Source of the Problem.

P Moffitt1, A Williamson2, P Stenhouse3

  • 1Foundation Year 2 Doctor, Intensive Care Unit, Queen Elizabeth University Hospital, Glasgow.

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Summary
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A portable chest x-ray revealed a widened cardiac silhouette in an intubated patient. The electrocardiogram (ECG) showed sinus rhythm with significant ST elevation, suggesting acute cardiac injury.

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Area of Science:

  • Cardiology
  • Radiology
  • Emergency Medicine

Background:

  • Portable chest x-rays are crucial for assessing critically ill patients.
  • Electrocardiograms (ECGs) are vital for diagnosing acute cardiac events.

Purpose of the Study:

  • To report imaging and electrocardiogram findings in a patient presenting with potential acute cardiac injury.
  • To highlight the diagnostic utility of chest x-ray and ECG in critical care settings.

Main Methods:

  • Portable chest x-ray interpretation.
  • Electrocardiogram (ECG) analysis.

Main Results:

  • Chest x-ray demonstrated a widened cardiac silhouette and an endotracheal tube.
  • ECG revealed sinus rhythm with widespread mixed convex and concave ST elevation, particularly in leads V4, V5, and lateral leads.
  • PR depression was suggested in the inferior leads.

Conclusions:

  • The findings suggest a possible acute cardiac event requiring further investigation.
  • Integrated interpretation of chest x-ray and ECG is essential for prompt diagnosis and management.