Heart Failure & Valvular Diseases Q 18 - Gyan Darpan : Learning Portal
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Thursday 28 April 2022

Heart Failure & Valvular Diseases Q 18

Dyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms of which of the following conditions?
     A. Pericarditis
     B. Hypertension
     C. MI
     D. Heart failure

Correct Answer: D. Heart failure

These are the classic signs of failure. Acute and subacute presentations (days to weeks) are characterized by shortness of breath at rest and/or with exertion, orthopnea, paroxysmal nocturnal dyspnea, and right upper quadrant discomfort due to acute hepatic congestion (right heart failure). Chronic presentations (months) differ in that fatigue, anorexia, abdominal distension, and peripheral edema may be more pronounced than dyspnea.

Option A: Pericarditis is exhibited by a feeling of fullness in the chest and auscultation of a pericardial friction rub. The classic presentation is with chest pain that is central, severe, pleuritic (worsened with deep inspiration) and positional (improved by sitting up and leaning forward). The pain may also be radiating and may involve the ridges of the trapezius muscle if the phrenic nerve is inflamed as it traverses the pericardium.
Option B: Hypertension is usually exhibited by headaches, visual disturbances, and a flushed face. Some cases present directly with symptoms of end-organ damage as stroke-like symptoms or hypertensive encephalopathy, chest pain, shortness of breath, and acute pulmonary edema.
Option D: MI causes heart failure but isn’t related to these symptoms. Myocardial ischemia can present as chest pain, upper extremity pain, mandibular, or epigastric discomfort that occurs during exertion or at rest. Myocardial ischemia can also present as dyspnea or fatigue, which are known to be ischemic equivalents.

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