Test your clinical knowledge with the daily Case in Point program, which gives you the opportunity each weekday to work through a subspecialty case.

CASE OF THE DAY

A 46-year-old woman presents to the emergency room with an approximate 2-hour history of sudden-onset shortness of breath. She has a history of morbid obesity, diabetes mellitus, laparoscopic cholecystectomy, Roux-en-Y gastric bypass with revision 8 months prior, and perforated marginal gastric ulcer 4 months prior On admission, her vital signs are a temperature of 36.2°C, pulse rate of 120 per minute, blood pressure of 50/27 mm Hg, respiratory rate of 30 per minute, and oxygen saturation of 94%. The patient has ST elevation in the inferior and lateral leads on electrocardiogram and leukocytosis with a white blood cell count of 41,000 μL and 85.4% neutrophils. Her serial troponin is less than 0.012 ng/ml. There is no trauma, recent travel, or recent surgical history.