smalley
Forum Elite
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a 68 yr old man c/o increasing dyspnea on exertion.no h/o chest pain,nausea,diaphoresis,vomitting.had 10 car accidents in the last 4yrs
h/o ht for which he takes a diuretic.temp 37.3C BP 126/84,PULSE 76 rr 16 oxg sat 99
physicalexam shows diffuse lat displaced point of max intensity,s3 gallop
what is the most app next step in mgt
a)echocardiogram
b)excercise tolerance test
c)polysomnography
d)xray chest
e)cardiac catheterization
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| cool doctor
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A. it seems he has AS although but PE didnt mention any murmur
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| darkhorse
Forum Elite
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CXR
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| dr19
Forum Senior
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MR---->CXR
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| smalley
Forum Elite
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But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint-Isaiah 40:31
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| smalley
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can some1 pls tell the answer with expln?
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But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint-Isaiah 40:31
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| sprint123
Forum Guru
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Chronic hTN---> LVH--->Dispalced apicl impulse
Chronic HTN--->Impending cardiac failure---> Exertional dyspnea
Can the asnwer be Echocardiography?
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| smalley
Forum Elite
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the answer is
c)polysomnography
it is a case of osa(h/o car accidents,dyspnea etc) which can lead to left hrt failure
am still confused why could not the next most appr step in mgt be a) echocardiogram to rule out serious heart pathology?
can any1 pls explain?
thanks
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But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint-Isaiah 40:31
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| smalley
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Posts: 291
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any1?
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But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint-Isaiah 40:31
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| me007
Forum Guru
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it's just can't be polysomnography as the next step in pt with cardiac symptoms.
Have to diagnose cardiac failure if it is there and treat it and than might be if you want so, polisomno.
Where is the q from?
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| me007
Forum Guru
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next step is CXR, than - echo, if still not enough - MUGA scan.
it is like if pt is young women with chest pain and some other signs of GERD.
First what they want you to think is ECG.
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| smalley
Forum Elite
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thanks
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But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint-Isaiah 40:31
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