He presents hypertension (200/100 mmHg), tachycardia. (96 bpm), tachypnea (22 ... percapnia (pH α 7,43; PaO2 α 50 mm Hg; PaCO2 α 58 mm Hg). Questions:.
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Morbid obesity with respiratory manifestations
Victor Botnaru1ǡ£1ǡ
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1*, Eugenia Scutaru1ǡì1
Victor Botnaru1, Alexandru Corlateanu1, Victoria Sircu1*, Eugenia Scutaru1, Serghei Covantev1
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Ánea gambelor, bilateral (Figura 1). Este hipertensiv (200/110 mmHg), tahicardic (96 bpm), tahipneic (22 rpm), SaO2 70% ȋ££ȌǤ
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Male patient, age 44, university professor, non-smoker, presents pronounced dyspnea on exertion, at minimal effort, orthopnea, choking during sleep, loud snoring during sleep, breathing pauses during sleep reported by his wife, insomnias during night, nocturia 4-5 times/night, nocturnal xerostomia, nocturnal sweating, morning headache, fatigue, daytime sleepiness and high blood pressure. Patient mentions snoring for approximately 20 years, during this period he added over 170 kg of weight, the last 8 years he sleeps in half-seated position, hypertension for 16 years, ʹͺǡǣ glycated hemoglobin 7,5%. Physical examination revealed male with morbid obesity ȋαʹͷǡαͳͺʹ
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Ȍǡ pale skin, pronounced bilateral peripheral edema, trophic changes with the presence of ulcers bilaterally on legs (Figure 1). He presents hypertension (200/100 mmHg), tachycardia (96 bpm), tachypnea (22 bpm), SaO2 70% (without oxygen support).
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ǡ rhythmic and attenuated heart sound. Abdomen increased in volume from the adipose tissue, no pain during palpation. The Mallampati score was IV and Epworth Sleepiness Scale was 16 points. Chest X-ray was normal, ECG revealed signs of right ventricular strain. The EchoCG revealed moderate dilation of both atria, reduced ejection fraction (41%), severe right ventricle (RV) dilatation and moderate pulmonary hypertension (pulmonary artery systolic pressure 49 mm Hg). Spirometry at-
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