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

doi:10.1136/bmj.b6

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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

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

Correspondence to: S Serrano Villar sergio1serrano{at}yahoo.es

Accepted 7 October 2008

Mrs Barroso, a 38 year old woman, collapsed while working in our hospital laundry. She was transferred to the emergency department unconscious and hypotensive with no known cause. Her temperature was 36.1°C, respiratory rate 18 per minute, and blood pressure 50/35 mmHg. She had a sinus tachycardia with a heart rate of 118 beats per minute and a weak pulse. Her oxygen saturation was 91% on supplemental oxygen. …