Trial Short Case 1 April 2024

Case Summary

A 72-year-old female is under the care of orthopaedic team for a fractured NOF

She was reviewed on the ward for mild chest pain and underwent further work-up and imaging for this

Background

Hypertension

Paroxysmal AF

GORD

OA

Medications

Apixaban

Amlodipine

Atorvastatin

Omeprazole

Paracetamol

Oxycodone

Examination

90kg and 160cm

HR 72 bpm sinus currently

BP 145/85

JVP not elevated

Chest, decreased air entry bibasally but otherwise NAD

HSD, no obvious murmur

No peripheral oedema

Bloods

•Hb 112 / WCC 8.4 / Plt 196

•Na 134 / K 4.2 / Cr 77

•INR 1.8 / APTT 37

•HbA1c 5.6

•Trop 10

Questions

It’s 7PM, an urgent referral is made to Cardiothoracic surgery

You are the consultant on call

  1. What are your thoughts/concerns with this patient? What extra information do you want to know?

  2. What is your re-entry/cannulation strategy?

  3. What is your surgical repair strategy?