- 35kg 10 yr old mn lab ret presented for decreased energy and appetite.
- PE showed tachycardia, grade I/IV cardiac murmur, ascites. CBC and chem profile were wnl.
- Rads showed cardiomegaly and ascites.
- Echo shows marked LV and RA dilation. I suspect RA dilation too but hard to assess as the LA is so large. There is a minor to moderate MVI. Meas. are as follows: IVSd=12.8,
- LVID=69.8, LVPWd=13.6, IVSs=15.6, LVIDs=52.6, LVPWs=15.7, FS=25%, EF=48%, EPSS=10.0mm.
- 35kg 10 yr old mn lab ret presented for decreased energy and appetite.
- PE showed tachycardia, grade I/IV cardiac murmur, ascites. CBC and chem profile were wnl.
- Rads showed cardiomegaly and ascites.
- Echo shows marked LV and RA dilation. I suspect RA dilation too but hard to assess as the LA is so large. There is a minor to moderate MVI. Meas. are as follows: IVSd=12.8,
- LVID=69.8, LVPWd=13.6, IVSs=15.6, LVIDs=52.6, LVPWs=15.7, FS=25%, EF=48%, EPSS=10.0mm.
- There is an irregular tachyarrhythmia 156-200bpm.
- During the scan I did not appreciate any significant pericardial effusion or cardiac masses. However, upon further review, I am seeing what could be a small amount of pericardial effusion on the M-mode transverse LV views. I am also concerned about the echogenic densities I am picking up in the off-angle right parasternal transverse pulmonary artery views. Is this just fat, consolidated lung, or could this be a tumor? The patient is not anemic.
Comments
Volume overload and
Volume overload and tachyarrythmia needs triple tx: lasix acei pimo) and consider myocarditis as well…treat th evolume firstadn see what the arrythmia does and that may bneed tx as well. need TR velocities and sweep of the abdominal cvc/ao ratio and hepatic veins to see if PHT and right chf is present as that may need sildenafil too but stage to the 4th med if needed.