Saturday, October 8, 2011

Choose the Single most Useful Diagnostic Method


A 48-year-old woman  with ankle edema and typical clinical findings of right sided heart failure
comes to you for the first time. She immigrated to the United States from
Vietnam 8 years ago. Her personal and medical history is not remarkable except family
history of tuberculosis.
The heart sounds are quiet, and both the lungs are also clear.
Chest x-ray is normal. ECG shows low voltage in the limb leads
but is otherwise normal. A Transthoracic Echocardiogram is inconclusive because of poor acoustical
windows.
The single most useful test in this situation is:

  1. Holter Monitor
  2. TEE
  3.  EBCT
  4. Cardiac MRI
  5.  PET with 18F FDG


Please Leave your answers and explanations in the Comment Box below.

3 comments:

  1. The differential would be between CCP Vs RCMP. CT is a gud choice, however even Cardiac MR can help in identifying a structural heart disease. PET, Holter & TEE will not add to the diagnostic yield.

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  2. I agree with you Sir, CT is a good choice for visualizing pericardium.

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  3. i think CT is investigation of choice to look for pericardial disease as the patient also had a past h/o TB....

    ReplyDelete