Cardiovascular System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This young man has presented with shock, as demonstrated by the marked tachycardia, unrecordable blood pressure, and presence of confusion (indicating poor end-organ perfusion); this is a medical emergency.\n\nThe presence of flushing and widespread petechiae, along with the antecedent history of fever, headache, and arthralgia, and recent travel to Sri Lanka raises the spectre of Dengue fever, which is a major public health problem in that country.\n\nThus, the possibility of Dengue shock syndrome (DSS) immediately comes to mind, as this is a common and potentially lethal complication of the disease; the underlying pathophysiology is a form of distributive shock, secondary to an increase in capillary permeability.\n\nAnother possibility is Dengu"}]}

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