Narrative Pedagogy
We know this is one way, but we are sure you all will make it one to one.
Young 13 year old girl, back ground
1. Turner syndrome.
2. Recurrent Cellulitis and Shingles
3. Recent diagnosis of Crohn’s disease being followed up by the infectious diseases and immunology teams.
She presented to the clinic with a history of progressively worsening breathlessness over approximately three weeks.
No history of fever, cough or otherwise being unwell. No history of otherwise being unwell.
She had already been seen by her GP and was started on amoxicillin for a presumed chest infection.
Question 1. What are the causes of Exertional dyspnoea -
Cardiac causes are the most common, particularly heart failure, which is typically graded into four classes based on severity.
Respiratory causes - bronchial asthma
Haematological causes - severe anaemia, significant polycythaemia.
Initial Clinical Assessment
Did not look unwell, slightly pale.
Slightly tachypnoeic, with a heart rate of around 100 beats per minute. Unfortunately, blood pressure was not recorded at that time.
Chest - clear. Cardiac examination- reported to be normal
Chest X-ray was requested, and the patient was sent home while awaiting the results.
Question 2. What is the diagnosis ? Differential diagnosis?
ECG
