Unexplained cardioresp symptoms, ? for VATS

Gabrielle Morris

Patient discussed at PIG last week. 

RUL presumed malignancy

Background

  • PET avid chest wall lesions – skin cancer
  • Schizophrenia 
  • COPD – normal spirometry, chest clear, nil recent exac
  • Palpitations – frequent, long lasting, associated chest pain, diaphoresis, dizziness 
  • SOBOE 20m
  • New chest pain, lasting up to 10 mins, right sided radiating through to back, heavy sensation, at rest
  • DASI 3.7 mets 
  • Stress TTE and holter monitor showed no cause for symptoms (including patient experiencing symptoms despite concurrent negative Holter reading)

Issues 

  • ? cause for symptoms, ? suitable to proceed to surgery

Discussion

  • Major cardioresp issues have been excluded
  • The cause of her symptoms is unlikely something fixable (or needing to be fixed)
  • Likely treatable lesion in chest, delays to surgery should be avoided where possible

Plan 

  • Proceed to surgery