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cardio

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5 Posts

NE
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Topics: 53
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05/22/07 - 04:18 PM

A 60-year-old man comes to the emergency department with increasing dyspnea over the past 1 month. His past medical history is notable for esophageal cancer for which he underwent radiation treatment and resection. He also reports occasional palpitations. He has an irregular pulse at 110/min. Blood pressure is 120/60 mm Hg with a pulsus of 6 mm of mercury with inspiration. Jugular venous distention is 14 cm of water with a prominent y descent. Cardiac examination reveals an irregular rhythm and variable S1 and S2. The patient has a palpable liver and 2+ edema in his extremities. Electrocardiogram reveals atrial fibrillation and low QRS voltage. Echocardiogram shows no pericardial effusion. Which of the following would be appropriate to determine the diagnosis?

A. Cardiac magnetic resonance imaging
B. CT scan of the lungs
C. Esophagoduodenostomy
D. Exercise stress test
E. Transesophageal echocardiography

hanialkhadher
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Topics: 18
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05/22/07 - 04:30 PM

A.MRI

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ssrpk
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Topics: 154
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05/22/07 - 04:36 PM

probaly metastatic invasion of myocardium resulting in restrictive disease
I agree with A

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sprint123
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Topics: 129
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05/24/07 - 02:13 PM

I am thinking of constrictive pericarditis due to radiation since metastasis-->RCM is rare--I suppose!

Wats the asnwer NE?

Justice
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Topics: 118
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05/24/07 - 02:20 PM

A. Cardiac magnetic resonance imaging to exclude/confirm constrictive pericarditis and post-radiation myocardial dystrophy

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