MEDizzy - A 46-year-old Japanese-American woman presents to her

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USMLE I Test Block III

A 46-year-old Japanese-American woman presents to her primary care physicians with complaints of increasing shortness of breath, fatigue, chest pain, abdominal distension, and a fainting spell. She has a history of amyloidosis, for which she has been repeatedly hospitalized. Her ECG shows low-voltage QRS complexes. Her vital signs are stable, and her laboratory values are normal. Which of the following would be most helpful in establishing the correct diagnosis?

ExplanationThe correct answer is C. This woman has restrictive cardiomyopathy. This condition is often brought on by infiltrative diseases, such as amyloidosis, sarcoidosis, and carcinoid syndrome, and may lead to extensive cardiac damage. Due to increased myocardial stiffness, ventricular filling is impaired, leading to the manifestations of right heart failure. To identify this condition, it is helpful to obtain an echocardiogram to distinguish it from other possible causes (valvular and other cardiomyopathies). A cardiac catheterization could also be done.