Wed3November0844PM 7

A 27-year-old lady presents to you with shortness of breath and cough with clear sputum.

She is ten days post partum. She underwent a caesarean section; both the patient and her baby are otherwise well.

Her ECG is as follows:

Which of the following investigations should be done urgently?

(Please select 1 option)

Myocardial perfusion scan

24 hour tape

Bubble ECHO

Echocardiogram (transthoracic) Correct

Angiogram

Explanation

This lady is suffering with peri- or postpartum cardiomyopathy. Symptoms may present ten days before delivery and up to five months post delivery.

The presentation is usually that of congestive cardiac failure. The echocardiogram would reveal a diastolic dysfunction. Treatment is as for heart failure.

Other investigations to consider in such a presentation would be pulmonary embolus, hyperthyroidism and arrhythmia.

Answer Statistics

1

1%

2

1%

3

4%

4

84%

5

12%

Times answered: 286