{"title":"Image: Clubbing and hypoxia","authors":"Jerome B. Balbin MD, Jessica Carlo DO","doi":"10.1002/emp2.13291","DOIUrl":null,"url":null,"abstract":"<p>A 40-year-old male with no significant past medical history presented to the emergency department with a severe headache for 3 days. On physical examination, the patient appeared very uncomfortable and was hypoxic on room air to 86%. He was ambulatory with no apparent focal neurologic deficits, but his fingers were clubbed. Electrocardiogram showed normal sinus rhythm. Computed tomography (CT) angiogram of the chest incidentally revealed a portosystemic shunt in the left upper quadrant. CT brain and magnetic resonance imaging (MRI) brain with and without contrast were obtained (Figures 1 and 2).</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13291","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American College of Emergency Physicians open","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/emp2.13291","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
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Abstract
A 40-year-old male with no significant past medical history presented to the emergency department with a severe headache for 3 days. On physical examination, the patient appeared very uncomfortable and was hypoxic on room air to 86%. He was ambulatory with no apparent focal neurologic deficits, but his fingers were clubbed. Electrocardiogram showed normal sinus rhythm. Computed tomography (CT) angiogram of the chest incidentally revealed a portosystemic shunt in the left upper quadrant. CT brain and magnetic resonance imaging (MRI) brain with and without contrast were obtained (Figures 1 and 2).
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