Echo Features of Other Cardiomyopathies

Echo Features of Other Cardiomyopathies
Echo Features of Other Cardiomyopathies
1. A 40-year-old female is referred to you for evaluation of
exertional dyspnea. A transthoracic echocardiogram is
performed. Selected images are shown in Figure 31.1 and
Video 31.1.
Which of the following statements best describes the condition shown?
A. A ratio of compacted to noncompacted myocardium
>3:1 is a characteristic diagnostic criterion that balances
the sensitivity and specicity of 2D echocardiography.
B. Since familial occurrence is rare, screening echocardiography is not recommended for rst-degree relatives.
C. Prominent trabecular meshwork is seen primarily in
the anterior wall.
D. Left ventricular systolic function remains normal with
increasing age.
E. This condition may at times be confused with both
a dilated cardiomyopathy and an apical-variant
hypertrophic cardiomyopathy.
2. A 33-year-old male is admitted to the hospital with complaints of dizziness and a syncopal event. Telemetry monitoring is signicant for recurrent episodes of nonsustained
ventricular tachycardia. A transthoracic echocardiogram is
performed. Selected images are shown in Figures 31.2 and
31.3 and Videos 31.2 and 31.3.
Chapter 31
Echo Features of Other
Konstantinos P. Koulogiannis
Figure 31.1
Figure 31.2
Figure 31.3
(c) 2015 Wolters Kluwer. All Rights Reserved.
Chapter 31 Echo Features of Other Cardiomyopathies 269
Based on this information, what is the next best step in
establishing a primary diagnosis?
A. Left heart catheterization
B. Endomyocardial biopsy
C. Electrophysiologic study
D. Nuclear myocardial perfusion study
E. Cardiac MRI
3. You are asked to see a 51-year-old female in the emergency department. She complains of several hours of
moderate-intensity, persistent midsternal chest pressure.
Past medical history is signi†cant for hypertension that is
well controlled with Chlorthalidone and Lisinopril. She
is recently divorced, lives with her 16-year-old daughter,
and reports ongoing child custody problems with her
ex-spouse. Social history is signi†cant for smoking and
occasional use of marijuana in the past; she denies any
current illicit drug use.
An electrocardiogram is performed, which is signi†cant for
precordial (V1 to V4) ST-segment elevations, and the patient
is brought urgently to the cardiac catheterization lab for
coronary angiography. Coronary angiography is completed
and reveals normal coronary arteries. Provocative testing
performed with intracoronary acetylcholine injection is
unremarkable. A transthoracic echocardiogram is performed
following the cardiac catheterization (Figs. 31.4 and 31.5;
Videos 31.4 and 31.5).
Which of the following statements is most accurate given
the most likely diagnosis?
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