A 27-year-old woman is admitted with cough, shoness of breath, and palpitations. She has been relatively well for most of her life, but her mother gives a history that the patient had recurrent “pneumonia” as a child. The patient denies any sputum production. On examination, she appears anxious. Her neck veins are distended and she has a widened split second hea sound with little respiratory variation. A systolic ejection murmur in the pulmonic area is noted. Lung exam reveals bilateral crackles; mild ascites and pedal edema are also noted. EKG shows right axis detion. CXR is shown in.. The next diagnostic step is
Correct Answer: Echocardiogram
Description: The cardiac silhouette is normal in size, but the pulmonary vasculature is prominent and the AP window is full. The interlobar branches appear large. There is pulmonary plethora with increased vasculature, especially in the right lower zone and the left upper zone, with increase in size of the aerial shadows suggesting increased pulmonary blood flow The clinical syndrome described best fits the diagnosis of atrial septal defect with secondary pulmonary hypeension. The chest radiograph is consistent with pulmonary hypeension. Other options are inappropriate. The next diagnostic step would be to do an echocardiogram.
Category:
Radiology
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now