Cardiomyopathy: The Daily PANCE Blueprint
A 61-year-old female with a history of breast cancer and sarcoidosis presents with fatigue, dyspnea, and exercise intolerance for the past year. On physical exam, you note JVD, peripheral edema, and an S4 gallop. An EKG reveals low voltage QRS and bilateral atrial enlargement. Which of the following is the most likely diagnosis?
A. Hypertrophic cardiomyopathy
B. Dilated cardiomyopathy
C. Ischemic heart disease
D. Restrictive cardiomyopathy
E. Acute myocarditis
Answer and topic summary
The answer is D. Restrictive cardiomyopathy/b>
Restrictive heart disease is most commonly caused by amyloidosis, but can also be caused by radiation, sarcoidosis, scleroderma, and hemochromatosis. The restrictive cardiomyopathy decreases the compliance of ventricles and impairs diastolic filling, leading to congestion/backflow of blood back into the lungs and body. The presents symptoms are often fatigue and exercise intolerance. On physical exam, you may see signs of pulmonary and systemic congestion (weak pulses, peripheral edema, crackles, ascites, JVD, etc). EKG findings are often non-specific (LAE, low-voltage QRS, AV block, etc). Work-up includes TTE, cardiac MRI, and coronary cath to rule out ischemia. The definitive diagnosis would be an endomyocardial biopsy.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒PANCE Blueprint Cardiology ⇒ ⇒
