Cardiology Case Report: Shortness of Breath Plus Erythrocytosis

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This cardiology case report from Brady Pregerson, MD, features a woman in her 50s presenting with 3 days of body swelling and dyspnea. Check out the EKG and see if you can determine the correct diagnosis!


A woman in her early-50’s presents to the hospital with 3 days of body swelling and dyspnea. She is on Lasix but does not know why. She denies any chest pain, fever, cough or other complaints.


Vital signs are normal except for a pulse ox of 84% on room are and a respiratory rate of 24. BP is 112/77. Physical exam is otherwise normal except for swelling of both legs up to the hips. There are no rales or wheezes but slightly asymmetric breath sounds

An ECG is done:

Other Initial Diagnostic Testing:

  • CBC: Hb =19.3, Plt = 127, WBC = 16
  • Chem-7: normal
  • Cardiac: BNP: 855, trop 23
  • Imaging: CXR appears clear

What is the most cause of EKG findings and erythrocytosis in this patient?