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  #1  
Old 08-05-2013
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Embarrassed Peds question #10 (and last question!)

An ill'appearing 9 week old baby is brought to the emergency room. She is pale and dyspneic with a respiratory rate of 80 bpm. Her heart rate is 190 bpm, her heart sounds are slightly distant, S3 is heard and she has cardiomegaly on chest xray, lungs are clear. An Echocardiogram demonstrates poor ventricular function, dilated ventricles and dilatation of the left atrium. An EKG demonstrates low voltage QRS´s with Premature ventricular contractions. Which of the following is the most likely cause of these findings?
A. A viral infection
B. Protein deposition in the heart.
C. Pericardial sack inflammation.
D. Aberrant Left coronary anatomy.
E. Glycogen storage disease of the heart.
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Old 08-05-2013
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I think A., a viral pericarditis.
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Old 08-05-2013
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Ok..I pick D...aberrant left coronary anatomy. i believe this Hypoplastic left ventricle cardiac anamoly.
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Old 08-06-2013
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I think E , Pompe's disease causes cardiomyopathy
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Old 08-06-2013
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The correct answer is A. A viral cause, most likely Coxsackie virus is causing this little child symptoms; which are secondary to Congestive heart failure.
Out of all the options just by epidemiology and frequency A is the most likely diagnosis.

Answer B causes constrictive cardiomyopathy.. not a dilated one. Pompe disease is a rare cause of dilated cardiomyopathy and it would be accompanied by other symptoms as well like failure to thrive and general weakness.
Pericarditis doesnt present like this and aberrant left coronary anatomy eventho is likely it is extremely rare.

Hypoplastic left heart syndrome kids dont survive this long and nothing in the history and PE suggests this, also remember some kids may present with early cyanosis. This child is referred as PALE not CYANOTIC which is not the same.

geo82 is correct
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Old 08-06-2013
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Quote:
Originally Posted by XpaezX View Post
The correct answer is A. A viral cause, most likely Coxsackie virus is causing this little child symptoms; which are secondary to Congestive heart failure.
Out of all the options just by epidemiology and frequency A is the most likely diagnosis.

Answer B causes constrictive cardiomyopathy.. not a dilated one. Pompe disease is a rare cause of dilated cardiomyopathy and it would be accompanied by other symptoms as well like failure to thrive and general weakness.
Pericarditis doesnt present like this and aberrant left coronary anatomy eventho is likely it is extremely rare.

Hypoplastic left heart syndrome kids dont survive this long and nothing in the history and PE suggests this, also remember some kids may present with early cyanosis. This child is referred as PALE not CYANOTIC which is not the same.

geo82 is correct
lol just thought about the survival....thanks for the awesome questions
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