Foresee Your Next Patient Severe Carcinoid Heart Disease with Left-Sided Involvement

摘要

A 73-year-old woman with no known history of coronary artery disease presented to the emergency department with complaints of sudden-onset left-sided substernal chest pain characteristic of myocardial infarction, but no other symptoms such as flushing, hypotension, or bronchospasm. Physical examination. Her blood pressure was 168/76 mm Hg, her heart rate was 77 beats per min, her respiratory rate was 17 breaths per min, her temperature was 37.3°C, and her oxygen saturation was 100% via nasal cannula with a flow rate of 2 L per min. Auscultation of the heart revealed a regular rate and rhythm, with a grade 2/6 systolic murmur on the right second intercostal spaces radiating to the carotids, and a grade 3/6 holosystolic murmur on the left lower sternal border. Jugular venous distension was noted at the angle of the jaw. The rest of the physical examination results were unremarkable.