cardio qq - kiranraja

[ArchivalUser]

A 66-year-old retired carpenter presents with chronic shortness of breath upon exertion. He has smoked a pack of cigarettes per day for the past 5 years and drinks alcohol regularly. On physical examination, a displaced point of maximal impulse and hepatosplenomegaly are noted. His medications include pantoprazole
for gastroesophageal reflux and sertraline for depression. Echocardiogram reveals an ejection fraction of 30% and dilated left and right ventricles. Laboratory test results are:
Na−129 mEq/L
K-5.2 mEq/L
Cl−101 mEq/L
Blood urea nitrogen 45 mg/dL
Creatinine 1.3 mg/dL
Glucose 134 mg/dL
Aspartate aminotransferase 220 U/L
Alanine aminotransferase 140 U/L
Alkaline phosphatase 280 U/L

Which of the following is the most likely etiology
of his cardiac findings?
(A) Borrelia burgdorferi
(B) Cigarette smoking
© Coxsackie B virus
(d) Ethanol
(E) Pantoprazole toxicity
(F) Trypanosoma cruzi

[ArchivalUser]

dd

[ArchivalUser]

_ DDD

[ArchivalUser]

D

DCMP d/t alcohol
reversible

[ArchivalUser]

D fits, but how do you explain hepatosplenomegaly? Hepatomegaly occurs in acute alcoholic hepatitis (fatty liver too), but is not associated with splenomegaly. Splenomegaly would only occur if cirrhotic, by which time liver would be normal sized or small??

[ArchivalUser]

he correct answer is D.
Dilated cardiomyopathy
is a common cause of congestive heart
failure. It is usually due to causes such as ischemic
heart disease or hypertension, but in
this case, it is likely due to the toxic effects of
chronic alcohol consumption. The liver function
tests and physical examination results are
consistent with chronic alcoholism and alcoholic
cirrhosis.

[ArchivalUser]

AST>ALT if you drink A Scoth n Tonic