Fro
Ref.
Tel. No.
Date
G.F. 734
Dr. S.M. KONG, Cons.Phy.,
Medical Unit 'B', Q.E.H.
in H.N. 93255/78
Ext. 42
18th December, 1978.
MEMO
О
To
Medical Superintendent, Q.E.H.
Your Ref............ in
dated
Re: Mr. R.A.B. White, M/33
The above-named was admitted to Q.E.H. on 2.10.78 in coma. Information from one of his colleagues revealed that after jogging for 8 or 9 miles, he was observed to have swayed and staggered before bumping onto a sign-pole. He was also noted to have vomited once with some brownish material.
On admission he was unconscious with no response to pain and with pyrexia of 104 F. There was no signs of external injury except for minor abrasion over his left forehead. His limbs were held in extension with frequent twitching movement. 400 c.c. of dark bown fluid was aspirated from his stomach. His pulse 110/min. and B.P. 140/80 mmHg later dropping to 70/40 mmHg. He was given plasma while awaiting blood for transfusion. X-ray skull, x-ray chest, blood sugar and electrolyte were done with no abnormal finding. His E.C.G. showed tachycardia. Neurosurgical Unit was consulted for possibility of head injury. His condition deteriorated rapidly and he died 5 hours after admission despite treatment.
A post-mortem examination revealed evidence of gastrointestinal bleeding from small multiple erosions in gastric mucosa. There was also patchy pulmonary haemorrhage and congested lung. The heart was enlarged with much increase in weight and thickness of the myocardia., The coronary arteries were patent. The brain showed no evidence of in jury or haemorrhage.
The final diagnosis was Cardiomyopathy with gastro-intestinal and intrapulmonary haemorrhage.
SMK/cc
1
(S.M. KCMG) Consultant Physician, Medical Unit 'B', Queen Elizabeth Hospital.