"I can barely get out of bed."



63 year old female with h/o hypertension, hyperlipidemia, asthma, motor vehicle accident requiring multiple abdominal surgeries 5 years prior who presents to the hospital with severe fatigue.


Starting 1 week ago, she had been having progressively worse fatigue, malaise and shortness of breath, associated with low grade fevers. No cough, vomiting, diarrhea or abdominal pain. Was previously in her normal state of health, taking stairs, driving, walking her dog with no issues. Now she can barely go up a few steps without feeling very fatigued.


Denies any orthopnea, PND or lower extremity edema. Nonsmoker, no history of known lung disease apart from mild asthma. Has been isolating herself inside during the COVID19 pandemic. Has not been exposed to anyone with COVID19 as far as she knows.


VITALS


T 99.7 HR 115 BP 133/76 SPO2 97% on room air


RELEVANT LABS


WBC 9k Hgb 11 Plt 250k


BUN 50 Cr 0.9


LFTs unremarkable


POCUS EXAM

LUNG, Anterior


Lung, Posterior


CARDIAC


Parasternal Long Axis


Parasternal Short Axis


Apical 4 Chamber View


Blood and urine cultures are pending.



What is the diagnosis?




Click here to for the answers and lesson.



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