03-07-2008, 02:58 PM
A 28-year-old woman develops fatigue and
orthopnea 3 weeks after
the uncomplicated delivery of her first child. Her
blood pressure is
115/78 mm Hg, and pulse is 112/min. Crackles are
heard at both lung
bases. The point of maximal impulse is laterally
displaced and diffuse;
an S3 is present. There is 2+ pedal edema. An x-ray
film of the chest
shows vascular cephalization of pulmonary vasculature
and Kerley B lines.
Which of the following is the most appropriate next
step in management?
A
) Measurement of serum creatine kinase and lactate
dehydrogenase
activities
B
) Echocardiography
C
) Dipyridamole thallium scan
D
) Ventilation-perfusion lung scans
E
) Myocardial biopsy
is this peri partum cardiomyopathy?
orthopnea 3 weeks after
the uncomplicated delivery of her first child. Her
blood pressure is
115/78 mm Hg, and pulse is 112/min. Crackles are
heard at both lung
bases. The point of maximal impulse is laterally
displaced and diffuse;
an S3 is present. There is 2+ pedal edema. An x-ray
film of the chest
shows vascular cephalization of pulmonary vasculature
and Kerley B lines.
Which of the following is the most appropriate next
step in management?
A
) Measurement of serum creatine kinase and lactate
dehydrogenase
activities
B
) Echocardiography
C
) Dipyridamole thallium scan
D
) Ventilation-perfusion lung scans
E
) Myocardial biopsy
is this peri partum cardiomyopathy?