A Prescription For Exercise Avoidance

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A Prescription For Exercise Avoidance - Page #3

Lab Studies: Potassium: 3.7. Creatinine: 0.9. Glucose: 120. Magneisum: 1.7. Hgb: 13.0. MCV: 79. Troponins 0.66 then 6.0. TSH 12.1. free T4: 0.96. Urine toxicology negative. Urine pregnancy negative. Chest radiograph without infiltrates or cardiac enlargement. D-dimer negative. Other Studies: 1st EKG: Wide complex tachycardia at 225 bpm, left bundle left inferior axis. 2nd EKG after resolution of wide complex tachycardia: T-wave inversions in V1-V3 and multiform PVCs. Transthoracic echocardiogram: Normal LV size and function. Concern for RV apical hypokinesis. No valvular abnormalities. Cardiac catheterization with coronary angiography: Angiographically normal coronary arteries. Left ventricular end diastolic pressure normal. Cardiac MRI: Decreased RVEF at 32%. Borderline low LVEF at 54%. Electrophysiology study: Several PVC morphologies noted; predominately left bundle axis and superiorly oriented. No inducible tachycardia. Consultations: Cardiology Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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