A 38 year old woman with hypotensive shock at the onset of menstruation: case presentation

doi:10.1136/bmj.b6

Published 9 February 2009, doi:10.1136/bmj.b6
Cite this as: BMJ 2009;338:b6

Practice

A 38 year old woman with hypotensive shock at the onset of menstruation: case presentation

Sergio Serrano Villar, resident in internal medicine¹, Juncal Perez-Somarriba, consultant in internal medicine ¹, Talia Sainz Costa, resident in paediatrics¹, Sarah Winstanley, foundation doctor², Tomas Santillana Lopez, consultant in internal medicine¹, Luis Escribano Mora, consultant in haematology³, Baltasar Orejas Gonzalez, professor in internal medicine¹

¹ Hospital Clinico San Carlos, Madrid 28040, Spain, ² Kingston Hospital, London, ³ Centro de Estudios de Mastocitosis de Castilla la Mancha, Hospital Virgen del Valle, Toledo, Spain

Correspondence to: S Serrano Villar sergio1serrano@yahoo.es

The first 150 words of the full text of this article appear below.

Mrs Barroso, a 38 year old woman, collapsed while working inour hospital laundry. She was transferred to the emergency departmentunconscious and hypotensive with no known cause. Her temperaturewas 36.1°C, respiratory rate 18 per minute, and blood pressure50/35 mmHg. She had a sinus tachycardia with a heart rate of118 beats per minute and a weak pulse. Her oxygen saturationwas 91% on supplemental oxygen. She was responsive to vigorousverbal stimuli and her pupils were equal and reactive to light.Physical examination found no other abnormalities. Relativesreported to the medical team that she had complained of abdominalpain and diarrhoea since she had begun menstruating the nightbefore.

In the emergency department haemodynamic support was startedand a total of 4500 ml of fluid replacement was administeredintravenously. The box lists the results of biochemical investigations.Chest (figure) and abdominal radiography showed no abnormality,. . . [Full text of this article]

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This article has been cited by other articles:

Peile, E. (2009). Commentary: The value of complexity. BMJ 338: b796-b796 [Full text]
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