Case - Overweight, some edema
Hints page


I. The Case (& preliminary "hints")

Case - Overweight, some edema

II. The Chart

We examine the information revealed in HUMAN by selecting < Your Patient's Chart > ...

... noting "hadn't been feeling up to par" and the additional hint of "some edema."

III. Testing cardiovascular status

Suspecting possible cardiovascular difficulties ('some edema'), we ask for a profile of cardiovascular status.

A] Obtaining CV information via the traditional method setting of HUMAN output tables

• we set up our output tables as below

These are, left to right, mean arterial pressure (AP), cardiac output, vascular conductance, mean circulatory filling pressure, left atrial pressure (LAP) and lymph flow. [Remember to use Help in the main model to review/get info of variables as needed.]

• we observe the results

B] Observations on the data

We see a patient who

• is hypotensive (arterial pressure = 91.0 vs. ≈ 100 mmHg normally)

• shows a markedly low cardiac output (4.2 vs. 5.5 L/M expected)

• shows the low cardiac output despite elevated filling pressures (elevated LAP and MCFP) and

• has indications of a tendency toward edema as shown by substantially elevated lymph flows 7.28 vs. 2.5 baseline ml/min. .

C] Note that much of the same data can be obtained by asking for a Circulation Summary under View: <Patient charts or lab tests>

The parallel results are shown below


D] If we continue to follow the patient forward in time ( 2 days, 12 hour printouts) his values worsen demonstrating progressive deterioration.


V. More

This ends the hints section, part 1, on this case.

You should attempt again at this point to arrive at a diagnosis and, where possible, a treatment. To do so

Return to the HUMAN model's Physiology Lab section for this patient and verify

- the diagnosis by finding the appropriate variables to support your argument and

- the treatment by changing parameters so as to stabilize the patient.

VI. Hints section, part 2

If you wish further hints on this case click the link to the right [ second hint page ]


VII. Analysis

If you wish further analysis and a diagnosis on this case and information on how it was created, click on this link ( analysis ) and log in as requested.

* Note: Case hints and analyses are based heavily on Drs. Randall and Coleman's HUMAN-80 Instructor's Manual supplemented by notes of Dr. Coleman's in the model code itself and findings by myself and other colleagues over our years of use of these cases.