Question

A 45 year old salesman who has been previously healthy and athletically active develops progressive shortness of breath and weakness 3mo following a respiratory illness. CXR reveals a large heart shadow and congested lungs. Echocardiogram reveals EF 20% and moderate mitral regurgitation. Cardiac catheterization shows normal coronary arteries and confirms and EF of less than 25% with poor ventricular contraction and dilation. What is the likely diagnosis?

Answer 1

The likely diagnosis for a 45-year-old man with progressive shortness of breath and weakness after respiratory illness, a large heart shadow, congested lungs, EF of 20%, and moderate mitral regurgitation with normal coronary arteries is dilated cardiomyopathy.

Step-by-step explanation:

A 45-year-old previously healthy and athletically active salesman who developed progressive shortness of breath and weakness 3 months following a respiratory illness likely has a diagnosis of dilated cardiomyopathy. This conclusion is based on his clinical presentation and diagnostic findings such as a large heart shadow on chest X-ray, congested lungs, and an echocardiogram revealing an ejection fraction (EF) of 20% and moderate mitral regurgitation. The cardiac catheterization, showing normal coronary arteries, rules out ischemic heart disease as a cause of the poor ventricular contraction and dilation, further supporting the diagnosis of dilated cardiomyopathy. This condition is characterized by dilation of the heart chambers and impaired systolic function, leading to heart failure symptoms such as dyspnea and fatigue.