new_n_lost
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A 51 year old businessman complains of dyspnoea on exertion. He recently returned from a business trip to the UK. He has distant heart sounds on auscultation of the chest. A chest radiograph reveals that there is a thin rim of calcification surrounding the cardiac outline.
Which of the following conditions is most likely responsible for these findings?
1) Uremia
2) Tuberculosis
3) Group B Coxsackie virus
4) Sarcoidosis
5) Metastatic carcinoma
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| Aashi
Forum Moderator
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2) multiple choices given above, can be the cause of constrictive pericarditis in this pt---> anyways going for Tuberculosis
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| usmle4me
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Acute tb would not cause calcification but reinfection can. the rest do cause pericarditis but not calcification.
So shall go with TB
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| new_n_lost
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The most likely diagnosis is a constrictive pericarditis. The most probable cause for this is previous tuberculous infection which may have occurred many years previously. Acute TB would usually cause a constrictive pericarditis secondary to a pericardial effusion, but is not normally associated with calcification.
Uremia can cause a constrictive pericarditis, as can a pericardial malignancy,
Coxsackie virus (secondary to a pericarditis) but calcification would be unusual.
Sarcoidosis can cause both pericardial as well as restrictive cardiomyopathy but calcification would be unusual.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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