RT Book, Section
A1 Malik, Mahim
A1 Kilic, Ahmet
A1 Whitson, Bryan A.
A2 Baliga, R. R.
A2 Abraham, William T.
SR Print(0)
ID 1161019028
T1 Heart-Lung Transplantation
T2 Color Atlas and Synopsis of Heart Failure
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071749381
LK accesscardiology.mhmedical.com/content.aspx?aid=1161019028
RD 2024/04/23
AB A  37-year-old  woman  is  admitted  to  a  hospital  with  progressive  dyspnea  on  minimal  effort,  with  significant  worsening  in  the  past  6  months.  She  states  that  she  was  diagnosed  with  heart  murmur  when  she  was  5  years  old,  but  has  had  no  treatment  for  it.  She  describes  breathlessness,  fatigue,  and  occasional  presyncopal  episodes.  On  examination  she  has  dyspnea  on  exertion,  3+  bilateral  lower  extremity  edema,  ascites,  and  orthopnea.  She  has  clubbing,  tachypnea,  mild  right  upper  quadrant  tenderness,  and  some  bruising  on  her  extremities.  Chest  x-ray  demonstrates  an  enlarged  pulmonary  artery  silhouette.  Transthoracic  echocardiogram  demonstrates  a  large  ventricular  septal  defect  with  right  to  left  shunt,  right  ventricular  (RV)  enlargement,  and  an  elevated  estimated  RV  systolic  pressure.