A 60-year-old female patient with previous lymphoma has been referred to cardiology clinic with breathlessness. She has previously received mediastinal radiotherapy.
Which one of the following is unlikely to be a cardiac cause of her symptoms?
Left-sided valve lesions are much more common than pulmonary or tricuspid valve involvement in post-radiotherapy patients. The reasons for this are unclear. Coronary Heart failure | answers 63 disease is a risk due to intimal proliferation and accelerated atherosclerosis, even in the absence of traditional risk factors. Sick sinus syndrome and even complete heart block due to fibrosis have been seen. Constrictive pericarditis is a long-term sequela of radiation therapy and presents with signs of right heart failure. The treatment is pericardectomy.
A 52-year-old patient presents with breathlessness. He has had hypertension for many years but has been non-compliant with his medication. His echocardiogram demonstrates an EF of 70%, with marked concentric hypertrophy.
Which one of the following therapies is not appropriate?
The treatment for patients with hypertensive heart disease is adequate blood pressure control. However, not all agents are effective. ACE inhibitors and ARBs are the most effective, with calcium antagonists able to reduce LV mass. Atenolol is associated with a higher mortality because of its inability to prevent ventricular fibrillation.
A 42-year-old Caucasian woman presents to the outpatient clinic when she is 10 weeks pregnant. This is her second pregnancy and was unplanned. Her first pregnancy was complicated by peripartum cardiomyopathy with moderate impairment of left ventricular systolic function. However, she did have complete resolution of systolic function 6 months after the birth of her first child.
Which one of the following statements is true?
Patients with previous peripartum cardiomyopathy with complete resolution of LV function have a low mortality risk in subsequent pregnancies. The risk of re-developing the cardiomyopathy is higher, with 20% presenting with heart failure with a reduction in the likelihood of resolution of LV function. ACE inhibitors are contraindicated in the first trimester of pregnancy. Examination findings in preganancy can be very misleading as systolic murmurs, third heart sound, and ankle oedema can be detected in normal pregnancy.
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