Echocardiogram an Important Diagnostic Tool in the Intensive Care Unit - A Case of Chronic Hypoxia Induced Encephalopathy

Abstract

A 68-year-old patient was admitted in our hospital with on and off fever and cough for 1 month and disorientation for 5 days. On admission, patient was hemodynamically unstable and was unable to maintain saturation on 5 litre oxygen. Provisional diagnosis of sepsis induced AKI with encephalopathy was made. MRI Brain of the patient and CSF examination were normal while bedside 2D echocardiography revealed pressure and volume overload of right ventricle which led to low cardiac output state and hence likely the maintaining factor for disorientation. These echo findings helped in managing the inotropic and vasopressor support of the patient. Inotropic and vasopressor support was weaned over a period of 3-4 days and oral digoxin was added. To conclude, echocardiography is an important bedside tool to assess the cardiac performance. Altered mental status in patients with acute exacerbation of chronic obstructive pulmonary disease remains a pressing problem in the acute medical take. Bedside 2D echocardiography done at the right time by the intensivist remains a corner stone in the effective diagnosis and management of such patients.