robin082006
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A 60-year-old female comes to your office for evaluation of worsening breathlessness, ankle swelling and back pain. She has a 10 pack-year history of smoking and she drinks 2-3 glasses of wine each weekend. Her past medical history is insignificant. Her PR: 80/min; BP: 130/70 mmHg; Temperature: 37.1C(98.8F); RR: 14/min. Her examination is significant for jugular venous distension and bilateral ankle edema. There is an inspiratory increase in her jugular venous pulse. Chest auscultation shows basilar crepitations in both lungs. Heart sounds are distant and there is no murmur. Important laboratory findings are, serum calcium of 11.5 mg/dl, BUN of 40 and Cr of 2.0. Chest x-ray shows mild cardiomegaly. Echocardiography shows symmetrical thickening of the ventricular walls with a ‘speckled pattern’, normal ventricular dimensions and a slightly reduced systolic function. Based on these findings, which of the following is the most likely diagnosis in this patient?
A. Dilated cardiomyopathy secondary to alcoholism
B. Restrictive cardiomyopathy secondary to amyloidosis
C. Constrictive pericarditis
D. Dilated cardiomyopathy secondary to sarcoidosis
E. Dilated cardiomyopathy secondary to amyloidosis
F. Restrictive cardiomyopathy secondary to sarcoidosis
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| AAAAA
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A
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| Aashi
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B----->Restrictive cardiomyopathy secondary to amyloidosis
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| AAAAA
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B Reason is given on the echo:Echocardiography shows symmetrical thickening of the ventricular walls with a ‘speckled pattern’,
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| hanialkhadher
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how are you all, i am new here ,but i like what you do.
i think the answer is (F).
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| Guptashutosh
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its D , dilated myo due to sarcoidosis
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| robin082006
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ANSWER IS B, REMEMBER HINT "SPECKLED PATTERN"
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| prathapdoctor
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the answer is surely B only.echo findings are suggestive of restrictive cardiomyopathy.age of the patient,chronic history of back pain are pointing towards multiple myeloma leading to amyloidosis.
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