Final answer:
In a young, healthy patient suddenly presenting with CHF, hypertrophic cardiomyopathy and infective endocarditis should be considered, while coronary artery disease is less likely and pericarditis usually does not cause CHF. Echocardiogram and blood cultures are among the diagnostic tools used for infective endocarditis.
Step-by-step explanation:
Possible Causes of Sudden CHF in Young, Healthy Patients
In a young, healthy patient who suddenly presents with signs of congestive heart failure (CHF), several conditions need to be considered. Although coronary artery disease (CAD) is common in the general population, it is less likely to be the cause in younger patients without risk factors. Hypertrophic cardiomyopathy is a potential cause, as it can present with heart failure symptoms and is the most common genetic heart disorder. Moreover, infective endocarditis can lead to CHF due to the infection's damaging effects on the heart valves, which can rapidly become life-threatening if not treated promptly. However, pericarditis, which is an inflammation of the sac surrounding the heart, despite being a source of chest pain and other symptoms, does not typically present with CHF. Therefore, hypertrophic cardiomyopathy and infective endocarditis would be more suspect in a case of sudden CHF in a young, seemingly healthy individual. Infective endocarditis would be especially considered if the individual has a history of intravenous drug use, recent dental procedures, or any invasive procedures that could introduce bacteria into the bloodstream.
Differential diagnosis includes consideration for acute or subacute bacterial endocarditis where rapid valve destruction can occur, particularly with virulent organisms such as Staphylococcus aureus, or in patients with pre-existing valvular abnormalities. An echocardiogram along with blood cultures can help confirm an endocarditis diagnosis. For pericarditis, common symptoms include chest pain relieved by sitting forward and a pericardial rub heard on auscultation, with confirmation by echocardiogram or other imaging modalities.