Another case

Here is another case met by our hospital few weeks ago. The patient is a 25 year old male admitted to our hospital because of comminuted fracture of the humerus in a motor vehicle accident and internal fixation by plate and screws was done. 2 days after operation, the patient suffered of dyspnea and tachypnea of sudden onset. His blood pressure was 80/40 and heart rate was 145 bpm. He was transferred to the ICU. His oxygen saturation was low (in 80's) and the chest exam revealed generalized sibilant rhonchi. The followinf ECG was obtained.






Pulmonary embolism was suspected but, unfortunately there was no availible CT or echocardiography in our hospital by that time. The attending physician thought he might loose the patient if he referred him to another hospital because the patient's condition was getting worse despite i.v. fluids oxygen inhalation and bronchodilators. He decided to give thrombolytic therapy. After receiving the streptokinase the patient's condition improved markedly. Here is the ECG obtained after finishing streptokinase infusion.