Physical Address

304 North Cardinal St.
Dorchester Center, MA 02124

Atrioventricular Optimization by Transthoracic Echocardiography in a Patient with Interatrial Delay


Age Gender Occupation Working Diagnosis
71 Years Male Retired Congestive Heart Failure and Post–Cardiac Resynchronization Therapy Status

History

The patient had a history of acute myocardial infarction with triple vessel disease and underwent coronary artery bypass surgery.

Comments

This patient had congestive heart failure with an ischemic cause.

Current Medications

The patient was taking aspirin 80 mg daily, candesartan 8 mg daily, furosemide 40 mg daily, metoprolol 50 mg twice daily, and simvastatin 20 mg daily.

Comments

This patient was on optimal medical therapy.

Current Symptoms

The patient exhibited mild shortness of breath on exertion.

Comments

This patient was in New York Health Association class II.

Physical Examination

  • BP/HR: 157/80 mm Hg/82 bpm

  • Height/weight: 160 cm/56 kg

  • Neck veins: Normal

  • Lungs/chest: Clear

  • Heart: Jugular venous pressure not elevated, apex beat at anterior axillary line of the sixth intercostal space, heart sounds normal, no murmur detected

  • Abdomen: Soft, nontender

  • Extremities: No edema

Comments

The patient had a dilated left ventricle.

Laboratory Data

  • Hemoglobin: 13 g/dL

  • Hematocrit/packed cell volume: 0.462

  • Mean corpuscular volume: 89.3 fL

  • Platelet count: 142 × 10 3 /µL

  • Sodium: 141 mmol/L

  • Potassium: 4.1 mmol/L

  • Creatinine: 119 μmol/L

  • Blood urea nitrogen: 6.9 mmol/L

Comments

The patient’s laboratory tests were normal.

Electrocardiogram

You're Reading a Preview

Become a Clinical Tree membership for Full access and enjoy Unlimited articles

Become membership

If you are a member. Log in here