SJLD Aug 1, 2012:

I would lean towards (acute) cardiac decompensation with pulmonary congestion.
If you deliver now, you must provide a note explaining your reticence about this term.

Lara Barnett (asker) Aug 1, 2012:

@ SJLD Thank you. I shall use "pulmonary filling" in the meantime until any agrees appear. This is too close to the deadline now to hang around. Do you think using this term will avoid being too specific when we don't know? Or would "decompensated congestive heart failure" be OK in the circumstances?
ps. her previous history shows arterial hypertension.

SJLD Aug 1, 2012:

No, enlargement is not correct. However, the full context suggests only left-sided heart failure, since there are no signs of peripheral congestion (oedema).

If there is no past history of heart failure, we can't say it's decompensated HF.
In short, it's not really clear. Réplétion here refers to vascular filling - probably pulmonary congestion > acute cardiac decompensation (heart failure) with pulmonary oedema.

With a bit of luck, another MD might drop by to give an opinion.

Lara Barnett (asker) Aug 1, 2012:

Also A follow-up cardiac ultrasound was performed and shows a concentric hypertrophy with normal systolic function with an ejection fraction of 68%. The filling pressures are not elevated. There is no significant valvulopathy and there is a small amount of aortic impairment. Aortic root of normal calibre. Right cavities, inferior vena cava, not dilated. Good right ventricular contractility. No PAH detectable.

Lara Barnett (asker) Aug 1, 2012:

@ SJLD Full context in view of your comment The patient was originally admitted with "douleurs cervicales et difficultés à respirer depuis une semaine". Patient then diagnosed with "un sepsis d'origine trachéo-bronchitique".
Further problems appearing: "Une détresse respiratoire aigue avec un érythème cervical et sous-maxillaire. Une consultation ORL confirme une laryngo-épiglotite infectée compliquée de phlegmon."
On further examination was found: "patiente tres dyspnéique avec tension artérielle à 14/9 pouls à 115, température à 37.5%, saturation à 95% sous air ambient. Examen cardio-vasculaire: rythme régulier, B1 B2 normaux rapides. Examen pleuro-pulmonaire, murmure vésiculaire très diminue, rales crépitants bilatéraux avec freinage expiratoire et inspiratoire. Abdomen souple, les bruits intestinaux sont présents. Les mollets sont souples, indolores, pas d'oedème des membres inferieurs."

I acutally inserted "cardiac decompensation due to enlargement." (after you dipped last night). Would "enlargement" be wrong here?

Please tell me when you have read this discussion entry as I would like to delete it if it is not necessary on this web page. (don't like posting too much sensitive info from clients like this).

Lara Barnett (asker) Jul 31, 2012:

repletion/satiation I sort of got the same idea about the meaning, I just thought satiation meant that. I didn't know it is only related to appetites.

SJLD Jul 31, 2012:

Sorry but I'm dipping out now.

SJLD Jul 31, 2012:

réplétion Nothing to do with appetites being satisfied.

http://www.medix.free.fr/cours/deshydratation-hyperhydratati...

L’hyperhydratation extracellulaire peut se traduire par plusieurs signes.

• Des signes de réplétion du secteur interstitiel : les oedèmes périphériques généralisés qui sont déclives, siègent aux chevilles en position debout, aux paupières au réveil, dans les lombes chez les patients alités et donnent le signe du godet.

Ces oedèmes peuvent également intéresser les séreuses (épanchement péricardique, pleural, ascite) et le secteur interstitiel pulmonaire (oedème aigu pulmonaire).

• Des signes de réplétion du secteur vasculaire rarement isolés : ils sont à type d’hypertension artérielle accompagnée d’un tableau d’insuffisance cardiaque aiguë.