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Old 07-14-2011
aksyonez's Avatar
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Question A 63 y/o man with SOB

A 63 year old man presents with chronic sob upon exertion. He has smoked 1 ppd for 5 years and drinks alcohol regurlarly. Physical reveals a displaces point of maximal impulse and hepatosplenomegaly. His meds include omeprazole for GERD and fluoxetine for depression. Echo reveals an ejection fraction of 30% and dialated left and right ventricles
Lab shows:

Na 129
K 5.2
Cl 101
BUN 45
Creatinine 1.3
Glucose : 134
AST : 220
ALt: 140
Alkaline phosphatase 280
Which of the following is the most likely casue of his cardiac findings?

A. Cigarette Smoking
B. Coxsackie B virus
C. Omeprazole therapy
D. Ethanol
E. Trypanosoma cruzi
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  #2  
Old 07-14-2011
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D)ethanol caused his dilated cardiomyopathy! He even has liver damage due to alcohol.
Chagas disease is rare in the USA.
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  #3  
Old 07-14-2011
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i m with ethanol
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Old 07-14-2011
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D. ethanol
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  #5  
Old 07-14-2011
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D. Ethanol
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  #6  
Old 07-14-2011
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dilated cardiomyopathy , elevated liver enzymes ------- ETHANOL
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Old 07-15-2011
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D. Ethanol
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Old 07-15-2011
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I think when AST>ALT shows ethanol hepatittis ...Usually ALT >AST
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Old 07-15-2011
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The correct answer id D. Dilated cardiomyopathy is a commo cause of CHF. The liver function tests and physical exam results are consistent with chronic alcoholism and alcoholic cirrhosis
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