ABSTRACT

Examination This man’s jugular venous pressure (JVP) is not raised. Heart sounds are normal. The chest is clear to auscultation, with no evidence of peripheral oedema. Abdominal examination is normal. There is no lymphadenopathy, clubbing or skin rashes. Musculoskeletal examination is normal. An ECG (Fig. 88.1) shows less than 1 mm ST elevation in the inferior leads; PR interval normal; QRS normal duration and shape. Axis was normal. A chest X-ray shows mild cardiomegaly on a PA film. Lung fields are clear. Observations: temperature 37.8°C, heart rate 101/min, blood pressure 145/62 mmHg, respiratory rate 20/min, SaO2 98 per cent on room air, blood sugar 5.2 mmol/L.