Statistics from Altmetric.com
- adult cardiology
- heart failure
- pacing & electrophysiology
A previously well man in his 70s presented with a 2 month history of progressive dyspnoea, peripheral oedema, and purpuric rash affecting his legs. On examination, he was hypoxic, had ascites, bipedal oedema, and purpura on his legs.
Bloods revealed a normocytic anaemia, renal failure, and hypoalbuminaemia. Urine dipstick was ++ protein with a urine protein/creatine ratio of 83 mg/mmol. Chest x-ray showed an elevated right hemidiaphragm. An electrocardiogram (ECG) showed sinus rhythm with first degree atrioventricular (AV) block and low voltage QRS complexes (figure 1).
CT of the chest–abdomen showed bilateral pulmonary emboli, ascites, and small kidneys with no focal lesions. The caecal wall was irregularly thickened, suggestive of malignancy or colitis …
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.