© 2004 Fellowship of Postgraduate Medicine
SELF ASSESSMENT QUESTION
Cardiology
A 67 year old woman with renal failure and sinus bradycardia
Department of Cardiology, Arrowe Park Hospital, Wirral
Correspondence to:
Correspondence to:
Dr Simon G Williams
Department of Cardiology, Arrowe Park Hospital, Arrowe Park Road, Upton, Wirral CH49 5PE, UK; drsgwilliams@hotmail.com
Accepted 7 February 2003
Answers on p48.
| The first 150 words of the full text of this article appear below. |
A 67 year old diabetic woman presented with a three week history of lethargy, general malaise, and episodes of pre-syncope. Past medical history included hypertension, which had been difficult to control. Three months previously, an angiotensin converting enzyme (ACE) inhibitor was prescribed and the dose of atenolol was increased (from 25 mg to 50 mg) in the diabetic outpatient clinic to optimise her blood pressure control. On admission, she looked pale and unwell. Clinical examination revealed signs of congestive heart failure, with a pulse of 30 beats/min (regular) and blood pressure of 104/71 mm Hg. Laboratory investigations revealed a haemoglobin concentration of 101 g/l (normal mean corpuscular volume), urea 37.1 mmol/l, creatinine 422 µmol/l, potassium 5.1 mmol/l, sodium 133 mmol/l, bicarbonate 7 mmol/l. Renal function three months before showed only mild impairment of renal function (urea 11.0 mmol/l, creatinine 155 mmol/l). An electrocardiogram (ECG) showed sinus bradycardia (rate 30
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A 67 year old woman with renal failure and sinus bradycardia
Postgrad. Med. J. 2004 80: 48.[Extract] [Full Text] [PDF]
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