[CASE] SOB in a patient with history of lobectomy in childhood
Man in his mid-forties presented to GP office with lower limbs edema and ascites which had developed within a month. He admitted that he had been experiencing exertional dyspnoea for about a year. PMH included well-controlled hypertension and left lower lobectomy with removal of VI-VIII ribs because of a tumor in childhood - there was no documentation available. He was reffered immediately to the hospital. This ECG was taken in ED. Strips show sinus tachycardia 100 bpm and normal axis. There is possible right atrial enlargement (P around 2,5 mm in II and 1,5mm in V1) and downward ST depression with biphasic T wave in inferior leads (II, III, aVF) - right ventricular strain pattern . While no voltage and morphologic criteria for right ventricle hypertrophy (RVH) were met, presence of right atrial enlargement and RV strain pattern may support such diagnosis. Lab tests showed highly elevated NT-proBNP level and normal renal function. Echo examina
