Inflammatory Dilated Cardiomyopathy Essay
This is a soap analysis for a patient with abnormal cardiac diagnostic test. Cardiac diagnostic test is a method of identifying heart condition. It has series of test like, chest x-ray, electrocardiogram, echocardiogram, MRI, CT scan, and angiogram. Inflammatory Dilated Cardiomyopathy Essay
Subjective
Chief complaint: chest pain and shortness of breath for two weeks.
HPI: patient presented with left-sided chest pain that was of acute onset stabbing in nature, radiating to the back and the left shoulder region. The pain was aggravated by exertion and relieved by rest. The patient reports shortness of breath, lightheadedness, and easy fatigability. There is a history of orthopnea, paroxysmal nocturnal dyspnea, and palpitation.
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Past Medical and Surgical History
The patient is known to have hypertension, hypercholesterolemia, and is not on any medication. There is no known history of food and drug allergy.
Family Social Economic History
The patient is a middle-aged male, single, unemployed, and indulges in drinking alcohol and smoking cigarettes. There is a history of coronary heart disease in the family.
Review of Systems
The affected system is the cardiovascular system. Other systems are not affected.
Objective
Vital Signs; blood pressure is at 168/96mmHg, the pulse rate at 128 beats per minute, and respiratory rate at 14 cycles per minute. On examination, the patient is in fair general condition with lower limb edema pitting non-tender. No jaundice, no pallor, no cyanosis, no lymphadenopathy. Inflammatory Dilated Cardiomyopathy Essay
Systemic Examination
The patient has engorged neck veins, hyperactive precordium at the 5th intercostal space mid-clavicular line. There is a palpable parasternal heave. On auscultation the patient has mitral valve regurgitation; S1 and S2 are heard with a pan-systolic murmur.
Diagnostic Test
The electrocardiogram showed irregular regular rhythm and tachycardia with abnormal Q and R waves, left axis deviation, and interventricular delays. The echocardiogram shows dilated cardiomyopathy. Chest x-ray showed enlarged cardiac shadow.
Assessment
The primary diagnosis is dilated cardiomyopathy due to the left axis deviation on ECG and thick walls on ECHO (Schultheiss, et al 2019). The differential diagnosis is coronary heart disease and rheumatic heart disease. These conditions present with chest pain, shortness of breath and orthopnea but they appear differently on ECG-ECHO and chest x-ray (Schultheiss, et al 2019).
Plan
The treatment plan for this patient involves both pharmacological and non-pharmacologic modalities (Kaya et al 2020). Pharmacological involves giving anti-hypertensive, statins for hypercholesterolemia, diuretics for edema, beta-blockers for tachycardia, and blood thinner like aspirin (Maisch & Pankuweit 2020). Non-pharmacological modalities involve adopting a healthy lifestyle like physical exercise, a healthy diet, and stop smoking (Weintraub et al 2017). Dilated cardiomyopathy is a heart disease that presents with an abnormal cardiac diagnostic test. Inflammatory Dilated Cardiomyopathy Essay
References
Schultheiss, H. P., Fairweather, D., Caforio, A. L., Escher, F., Hershberger, R. E., Lipshultz, S. E& Priori, S. G. (2019). Dilated cardiomyopathy Nature reviews Disease primers, 5(1), 1-19.
Kaya Raczek, & Rose, (2020) Myocarditis and dilated cardiomyopathy In the Autoimmune Diseases (pp. 1269-1284) Academic Press
Maisch, B., & Pankuweit, S. (2020). Inflammatory dilated cardiomyopathy. Herz, 1-9.
Weintraub Semsarian & Macdonald, (2017). Dilated cardiomyopathy The Lancet, 390(10092), 400-414. Inflammatory Dilated Cardiomyopathy Essay