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Clinical Problem-Solving
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Volume 335:340-341 August 1, 1996 Number 5
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The Domino Principle
Ronen Jaffe, M.D., and Doron Zahger, M.D.

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A 65-year-old woman collapsed on the street and was brought to the emergency room. No witnesses or family members were available to give further details. On arrival the patient was stuporous and could not communicate. She was not in respiratory distress. Her blood pressure was 75/35 mm Hg without pulsus paradoxus, her heart rate was 85 beats per minute and regular, and her temperature was 35.5°C.

This woman appears to be in hemodynamic shock. The differential diagnosis at this stage is broad. The main categories I would consider are hemorrhagic shock (possibly due to internal hemorrhage from, for example, a . . . [Full Text of this Article]

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From the Department of Medicine (R.J.) and the Coronary Care Unit (D.Z.), Hadassah University Hospital, Mt. Scopus, Jerusalem, Israel.

Address reprint requests to Dr. Zahger at the Coronary Care Unit, Department of Medicine, Hadassah University Hospital, Mt. Scopus, P.O. Box 24035, Jerusalem 91240, Israel.

References


Related Letters:

Anaphylaxis and Coronary Disease
Levy J. H., Shanewise J. S., Roth A., Zahger D., Jaffe R.
Extract | Full Text  
N Engl J Med 1996; 335:1925-1926, Dec 19, 1996. Correspondence

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