Saturday, December 16, 2006

Nephrology Cases / On Call Musings: Very Different Clinical Situations That Look Alike

A 65 year old man with known congestive heart failure presents with pulmonary infiltrates, respiratory failure, and a low serum sodium of 117. Is it primarily congestive heart failure or is it pneumonia with the low sodium related to SIADH? Surprisingly, it turned out to be the latter. This is a situation where a Swan-Ganz catheter was extremely useful.


Anonymous said...

happens in my practice all the time. Usually the cardiologist doesn't know any other diagnosis code for someone who's short of breath

Dr. J. said...

As a cardiologist, I resent that!

But I agree, I would have swan'd him.