Cardiomyopathy: The Daily PANCE Blueprint

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Cardiomyopathy: The Daily PANCE Blueprint

A 50-year-old male with a history of alcohol abuse presents with shortness of breath and lower extremity edema. Physical exam demonstrates bilateral crackles and jugular venous distension. CXR shows pulmonary edema and cardiomegaly. Echocardiogram shows a dilated left ventricle with reduced ejection fraction and normal wall thickness. Which of the following is the most likely diagnosis?

A. Hypertrophic cardiomyopathy
B. Restrictive cardiomyopathy
C. Acute pericarditis
D. Constrictive pericarditis
E. Dilated cardiomyopathy

Answer and topic summary

The answer is E. Dilated cardiomyopathy

Dilated cardiomyopathy (DMC) is defined by enlargement of the ventricles with systolic dysfunction but normal LV wall thickness. Causes include genetics (25-30% of the time), autoimmune (RA, sarcoidosis, scleroderma, etc), infections (Chagas disease, HIV, mycobacteria), infiltrative diseases (amyloidosis), nutritional issues (Kwashiorkor, thiamine deficiency), and other things like alcohol and chemotherapy agents. Clinical features include dysrhythmias and typical symptoms of heart failure. Diagnosis is confirmed with an echocardiogram. Patients should be given guideline-directed medical therapy for heart failure as indicated/tolerated.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Cardiology ⇒ Cardiomyopathy (PEARLS)⇒ Dilated Cardiomyopathy

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