Luckyall
Forum Guru
Topics: 11
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45 y/o F has a 3 months h/o persistent cough and incr in SOB. Denies chest pain,or other illnesses. BP=110/70, pulse=110/min. Diffuse basilar crackles & S3 gallop, but no murmur. ECG--> sinus tachycardia and nonspecific ST-T wave changes. Echo__> dilated LV and a hypokinetic heart. Most likely DG
1) Ac pericarditis with effusion
2) DCM
3) HCM
4) severe MVP
5) silent subendocardial infarct
Im oscilating btw. DCM and silent subendocard infarct, i lean toward DCM ...any oppinion ?
Please explain your answer !
Thanks and best of luck !
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| vallia
Forum Guru
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DCM most likely
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| suv
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Topics: 43
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DCM
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| Luckyall
Forum Guru
Topics: 11
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Thank you , guys, i appppppppppppreciate it ! Now im sure is DCM
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| Diego Casali
Forum Elite
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Posts: 235
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I agree with you.
Dilated cardiomyopathy is the most likely diagnosis.
1) Acute pericarditis with effusion is not correct because there is no pericardial effusion on echocardiogram and the patient has not chest pain.
3) Hypertrophic cardiomyopathy is not correct because an asymmetric ventricular septum is absent on echocardiogram.
4) Severe mitral valve prolapse is not correct because the classic diastolic murmur is absent.
5) Silent subendocardial infarct is not correct because the patient is a 45 year old woman with no risk factors predisposing her to AMI. She denies past chest pain and she hasn't diabetes, so AMI is not likely.
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