Step II uw cardio question

[250256]

The question is as the picture. I took it by my phone, the quality is pretty bad. Sorry for that!

My question is is this a dilated myopathy or pericardial effusion? How to differentiate?

I prefered dilated myopathy because:

infection before, nomal jugular venous pressure. I think the lung are clear to auscultation might show in dilated myopathy but I am not sure.

pericardial effusion:

also has infection, supposed to have distant heart sound, but not mentioned here.

Thanks！

 

[Myxedema]

A viral URI would be more likely to be the cause of pericarditis rather than dilated CMP. Also, given that JVP is normal and lungs are clear to auscultation (i.e. Sx of CHF are absent), pericarditis is much more likely.

Dilated CMP - Often caused by ischemic heart disease, Sx of CHF are present
Pericarditis - Often caused by viral infections, typical pleuritic chest pain and friction rub are present

 

[AndyRSC]

The finding on the CXR is the "water bottle heart" configuration, suggestive of pericardial effusion.

http://www.learningradiology.com/archives2007/COW 274-Pericardial effusion/perieffusioncorrect.html

 

[250256]

Thanks, Myxedema and AndyRSC