Table 1 Timeline
Dates | Relevant past medical history and interventions | ||
5 Sep 2016 | 27-year-old, G1P0, currently 36+6 weeks pregnant, antenatal course uncomplicated. Jehovah’s witness, valid Advanced Health Directive. History of palpitations, investigated with thyroid function tests and Holter monitor, results normal. Patient awaiting echocardiogram | ||
Dates | Summaries from initial and follow-up visits | Diagnostic testing (including dates) | Interventions |
6 Sep 2016 | Central chest pain and shortness of breath. Tachycardic and subcutaneous emphysema noted in neck and clavicles. Diagnosis made of esophageal rupture | Chest X-ray (6 Sep 2016) and CTPA (6 Sep 2016) revealed pneumomediastinum and subcutaneous emphysema | Treated conservatively. Moved to the high dependency unit, given supplemental oxygen, intravenously administered fluids, intravenously administered antibiotics |
7 Sep 2016–8 Sep 2016 | Follow-up: • patient’s symptoms resolved • patient compliant with treatment, nil adverse events | Serial chest X-rays daily 6 Sep 2016–8 Sep 2016 | Intravenously administered antibiotics regime changed to cover pneumonitis. Gradual return to oral intake |