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  #1  
Old 11-03-2012
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Question Heart failure, UW, 45 yo caucasian male

A 45-year-old Caucasian male presents to your office with exertional dyspnea and easy fatigability. He has not seen a physician for 10 years and has no knowledge of any medical problems. He does not take any medications. and admits to cigarette smoking and alcohol use. His BP is 170/90 mmHg and his heart rate is 80 beats per minute. There are bilateral lung crackles on physical exam. Which of the following set of laboratory findings would be most consistent with diastolic heart failure in this patient?



Left Ventricular Left Ventricular Left Ventricular
cavity Ejection Fraction End-Diastolic Pressure
A. Dilated Decreased Increased
B. Dilated Decreased Normal
C. Normal Decreased Decreased
D. Normal Decreased Increased
E. Normal Normal Increased
F. Dilated Normal Normal
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  #2  
Old 11-03-2012
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its A. due to alochal induced dilated cardiomyopathy.
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  #3  
Old 11-03-2012
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The answer says nothing about alko or cigarets. There shouldn't be a stop " He does not take any medications and admits to cigarette smoking and alcohol use. "
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Old 11-03-2012
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I think A)
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Old 11-03-2012
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Default my answer :)

E. Normal Normal Increased
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Old 11-03-2012
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Quote:
Originally Posted by pambam View Post
The answer says nothing about alko or cigarets. There shouldn't be a stop " He does not take any medications and admits to cigarette smoking and alcohol use. "
oh! i missed the catch point. it was DHF. in it
LV cavity sized : Normal
EF : Normal (as systolic function normal)
LV diastolic pressure : decreased( as in DHF filling is decreased)

but this isnt mention in any option. May be i am missing something!!!
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Old 11-03-2012
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yes, catch point is DHF and the right answer is one of i wrote above. think one more time. i'm gonna wait to write the correct coz maybe some people want to do it by themself.
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Old 11-03-2012
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Default My answer

I am thinking C - Diastolic heart failure =problem filling so cavity is normal but cannot fill right leading to decrease ejection fraction as well as decrease end systolic pressure. Hope I am thinking it out right; good question!
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Old 11-03-2012
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i think it's D-----

good question..thanks
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  #10  
Old 11-03-2012
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d) normal , decreased, increased
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Old 11-03-2012
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Quote:
Originally Posted by pambam View Post
A 45-year-old Caucasian male presents to your office with exertional dyspnea and easy fatigability. He has not seen a physician for 10 years and has no knowledge of any medical problems. He does not take any medications. and admits to cigarette smoking and alcohol use. His BP is 170/90 mmHg and his heart rate is 80 beats per minute. There are bilateral lung crackles on physical exam. Which of the following set of laboratory findings would be most consistent with diastolic heart failure in this patient?



Left Ventricular Left Ventricular Left Ventricular
cavity Ejection Fraction End-Diastolic Pressure
A. Dilated Decreased Increased
B. Dilated Decreased Normal
C. Normal Decreased Decreased
D. Normal Decreased Increased
E. Normal Normal Increased
F. Dilated Normal Normal
E seems to be the best choice
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Old 11-03-2012
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Quote:
Originally Posted by venky2600 View Post
i think it's D-----

good question..thanks

changing my answer to E......ejection fraction would be normal coz systolic function remains functional.........
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My answer is CC............
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  #14  
Old 11-04-2012
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The right answer is E


Diastolic heart failure is characterized by normal ventricular contractile performance (EF) but a decrease in ventricular diastolic compliance. As a result, ventricular end-diastolic pressure (EDP) must be increased to achieve a normal ventricular end-diastolic volume (EDV) and stroke volume. Systolic heart failure is a decrease in ventricular contractile performance which requires increases of ventricular EDV and therefore also EDP to achieve a normal stroke volume. In summary, diastolic failure increases only FDP, whereas systolic failure increases both EDP and FDV.
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The above post was thanked by:
mayankkaushal (02-12-2013), subbi (11-04-2012), swwal (08-25-2013), venky2600 (11-04-2012)



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