frontal
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A 26-year-old female is referred to you from an OB-GYN colleague due to the onset of extreme fatigue and dyspnea on exertion 3 months after her second vaginal delivery. By history, physical, and echocardiogram, which shows systolic dysfunction, you make the diagnosis of postpartum cardiomyopathy. Which of the following is correct? A) Postpartum cardiomyopathy may occur unexpectedly years after pregnancy and delivery B) About half of all patients will recover completely C) Since the condition is idiosyncratic, future pregnancy may be entered into with no greater than average risk D) The postpartum state will require a different therapeutic approach than typical dilated cardiomyopathies
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| alenka
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no clue...
B?
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| ARJ
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No ideaaaaaaaaaaaaaa
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| winai
Forum Newbie
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i think D ? no idea
don think cardiomyopathy is reversible injury,
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| lucky
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it's b
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| Renegade
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This is truly a tough one. I agree with Lucky: B.
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| frontal
Forum Guru
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Well done folks. The answer, I found out, is B. .
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| usmlegr
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its B.
Even if one does not know the answer with 100% certaintly, one can easily find it by ruling out what appers to be wrong, or make less sense.
A is wrong: Why would someone call it postpartum if it happend for example 30 years after delivery? We have plenty other types of cardiomyopathy to name it. {postpartum by definition is heart failure between last month of pregnancy and 5 months after delivery}
D is wrong: Almost all systolic (not HOCM, not hypertension) heart failures have more or less the same treatment! Drug dosing may differ but you give the same drugs.
C is wrong: A young mother (=young healthy heart) patient almost dies of heart failure because of pregnancy. Would you really recommend her to get pregnant again? {future pregnancy should be avoided!}
B is correct, 50% recover to an ejection fraction >50%, about 10% will die and about 10 percent will be in end stage heart failure requiring heart transplantation.
Edited by usmlegr on 10/08/05 - 05:13 AM
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| frontal
Forum Guru
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Good reasoning. Do note that pregnancy is not an absolute contraindication if complete recovery occurs, though of course, the risk of recurrence is substantial.
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| doc26inder
Forum Elite
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thats a good question i have actually seen a case unfortunately she died
the explaination is great
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