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Old 08-17-2011
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Question Breast cancer survivor w/ heart complications

A 60yr old breast cancer survivor visits her physician because of weakness, fatigue, fever, and weight gain 5yrs following her radiation therapy. the physician also elicits complaints about abdominal discomfort and exertional dyspnea. Physical examination reveals hepatomegaly and jugular venous distention that fails to subside on inspiration, but shows no evidence of hypotension or pulsus paradoxus. An ECG shows reduced end diastolic volumes and elevated diastolic pressures in both ventricles. Which of the following is the most likely diagnosis?

a. cardiac tamponade
b. congestive heart failure
c. constrictive pericarditis
d. dilated cardiomyopathy
e. recurrence of breast cancer
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b. congestive heart failure
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Default c

constrictive pericarditis
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Old 08-17-2011
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Originally Posted by ujustgotdoctored View Post
A 60yr old breast cancer survivor visits her physician because of weakness, fatigue, fever, and weight gain 5yrs following her radiation therapy. the physician also elicits complaints about abdominal discomfort and exertional dyspnea. Physical examination reveals hepatomegaly and jugular venous distention that fails to subside on inspiration, but shows no evidence of hypotension or pulsus paradoxus. An ECG shows reduced end diastolic volumes and elevated diastolic pressures in both ventricles. Which of the following is the most likely diagnosis?

a. cardiac tamponade
b. congestive heart failure
c. constrictive pericarditis
d. dilated cardiomyopathy
e. recurrence of breast cancer

it's constrictive pericarditis.
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Old 08-18-2011
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Default C. constrictive percarditis

C. Constrictive pericarditis interferes w/ the filling of the ventricles because of granulation tissue formation in the pericardium. The fact that both ventricles were affected could only be a pericarditis.

Its not:
A. because cardiac tamponade affects the R side and has a pulsus paradoxus
B or D. CHF and dilated hypertrophy will have increased diastolic volumes but in this pt the diastolic volumes are reduced
E. Even though Metastases to the pericardium are most commonly breast and lung carinomas, lymphomas, and melanomas It is still extremely rare and constrictive pericarditis is much more common.
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