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Old 07-07-2011
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Heart Next step in the management of this heart case!

A 53 yr old male presents with a complaint of progressive dyspnea. On examination ascitis, hepatomegaly is found. Past history of radiation therapy is given. ECG shows prominent p waves. Echo shows atrial enlargement with small ventricles. Next step in management?
A. Calcium channel blocker
B. Anticoagulant
C. Heart transplant
D. Steroids
E. NSAIDs
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Old 07-07-2011
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i think radiation has caused fibrosis of the myocardium and non complaince of ventricles, causing atrial enlargement and signs of HF, since no therapy for radiation injury is available, my answer is heart transplant.
Tough question, waiting for the correct answer
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Old 07-07-2011
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C. Heart transplant i think
restrictive CMP caused by radiation
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Old 07-07-2011
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Answer is A. calcium channel blocker.
Its restrictive cardiomyopathy. Main cause of it are systemic diseases,inborn error,malignency,radiation. Results in large atria but small ventricle with decrease compliance. Calcium channel blocker to support diastole.
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Old 07-08-2011
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Prominent P indicates P pulmonalae. This patient may well have pulmonary fibrosis (radiation induced) which secondarily causing pulmonary hypertension-right heart failure!

What do you think guys?

Then it is in the favour of heart-lungs transplant!
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Old 07-08-2011
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Quote:
Originally Posted by 1TA2B View Post
Prominent P indicates P pulmonalae. This patient may well have pulmonary fibrosis (radiation induced) which secondarily causing pulmonary hypertension-right heart failure!

What do you think guys?

Then it is in the favour of heart-lungs transplant!
yes but i think we should look at first step in management then...later transplant..but in btween calcium channel blocker, antiannhythmic, anticoagulent, ICD then transplant..ofcourse if with serious symptums whole approach changs.
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