Viva 3

Twenty-four hours after a TOE to facilitate the treatment of chronic AF, a 60-year-old female presents to the emergency department with acute, severe chest pain.

Her observations are as follows:

  • Heart rate 120 bpm, sinus
  • Systolic blood pressure 80 mmHg, improving to 110 mmHg after 1 L bolus of IV crystalloid
  • Respiratory rate 32/min
  • O2 saturation 92% on 6 L/min O2 via Hudson mask
What is your differential diagnosis?

(This viva dealt with oesophageal perforation.)

Disclaimer: the viva stem above may be an original CICM stem, acquired from their publicly available past papers. Or, perhaps it is a slightly altered version of the original CICM stem. Or, it is a completely original viva stem, concocted by the monstrously amoral author of Deranged Physiology for nothing more than his own personal amusement. In either case, because the college do not make the main viva text or marking criteria available, almost everything here has been confabulated. It might sound like a plausible viva and it could be used for the purpose of practice, but all should be aware that it does not represent the "true" canonical CICM viva station.