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  #1  
Old 04-09-2010
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Question Dyspnea and Edema and Cardiomegaly

A 42-year-old man presents to the ED with a complaint of increasing shortness of breath when walking to get his newspaper, difficulty
breathing while lying flat, and a 4.5-kg (10-lb) weight gain over the last month. He is afebrile, his pulse is 75/min, and his blood pressure is 98/50 mm Hg. On examination he smells of alcohol and has 2+ pitting edema in the lower extremities and a third heart sound. X-ray of the chest reveals cardiomegaly. What findings, other than those listed above, must be present in order to confirm this manís underlying diagnosis?
(A) Hepatojugular reflux and pulmonary congestion
(B) Left ventricular dilation and aortic insufficiency
(C) Left ventricular dilation and systolic dysfunction
(D) Myocardial thickening and diastolic dysfunction
(E) Pulmonary congestion and diastolic dysfunction
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  #2  
Old 04-09-2010
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Its C ... I think so ..... Dilated cardiomyopathy
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  #3  
Old 04-09-2010
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Answer is C, pt have DCM.
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Old 04-10-2010
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Arrow The correct answer is C

Yes guys you are right
The correct answer is C
This is dilated cardiomyopathy because of the alcoholic hint

Answer A is not correct because these finding not necessarily needed to establish the diagnosis of dilated cardiomyopathy.
Answer B is not correct because the question did not give any signs of AR and it's not needed for the diagnosis of DCM.
Answer D and E are incorrect because diastolic heart failure is seen in restrictive CM, ischemic heart disease, and LVH and not in dilated cardiomyopathy.
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