Boy with Dyspnoea and Angina

Tuesday, April 20, 2010
This is a PA chest Xray of 16 years old boy who came to the cardiology unit complaining of  shortness of breath which was aggravated on exertion and mild chest pain.And he also had frequent faints.
On examination he was found to have jerky pulse and systolic murmur which was best heard at the left lower sternal edge.


What is your diagnosis?
What are the ECG changes that you would expect in this condition?

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42 comments

  1. Anonymous Says:
  2. Aortic stenosis

     
  3. Anonymous Says:
  4. heart extended to the left- left ventricle..
    anamnesis and physical examination results fits for obstructive cardiomyopathy- subvalvular stenosis of aorta

     
  5. ilove me Says:
  6. hypervolumic condition

     
  7. ilove me Says:
  8. left atrial block

     
  9. Anonymous Says:
  10. aortic stenosis

     
  11. noor Says:
  12. left ventricular hypertrophy with patient presenting dyspnea and angina.we can also see the enlargement(small extent) of the ascending aorta..
    aortic stenosis.

     
  13. HappyDoc:) Says:
  14. Aortic stenosis has all these signs and symptoms.
    Boot-shaped aspect--->Left ventricular hypertrophy....which can also explain the dyspnea and angina.
    ECG may reveal..left ventricular hypertrophy,left atrial enlargement,Left Bundle Branch Block,AVblock...

     
  15. zaza Says:
  16. hypertrophic cardiomyopathy

    ECG:LVH;LA abnormality; Q-waves in precordial leads

     
  17. Anonymous Says:
  18. On the basis of history and CXR, i suggest it to be a dilated ( Hypertrophied)cardiomyopathy.

    other differentials could be, Hypertrophied left ventricle (In response to aortic stenosis)

    ecg changes would b tall R waves in leads 2, aVL, V2, V3, V4

     
  19. Anonymous Says:
  20. aortic stenosis

     
  21. I think this boy has a hypertrophic cardiomyopathy and the faints lead us to the obstructive type.
    ultrasound investigation will make the difference between aortic stenosis (concentric hypertrophy) and HOCM (asymmetric hypertrophy)

     
  22. Anonymous Says:
  23. HOCM,ECG CHANGES I THINK LBBB ,ST ELEVATION

     
  24. Anonymous Says:
  25. zamrak

    Hypertrophic cardiomyopathy

     
  26. HOCM.... symptoms are suggestive of either AS or HOCM. The ECG will be showing a Left Axis Deviation with evidence of LVH. Asyym. Spetal Hypertrophy, SAM, Septal Bounce and Dynamic LVOT obstruction and gradient in ECHO are diagnostic.

     
  27. Anonymous Says:
  28. Aortic stenosis

     
  29. ISLAM Says:
  30. THHIS XRAY SHOWS LVH ...A.S IS SUSPECTED.. FURTHER INVESTIGATION >>ECHO

     
  31. Anonymous Says:
  32. aortic stenosis
    ECG-LVH
    sadaf

     
  33. Anonymous Says:
  34. lvh

     
  35. Anonymous Says:
  36. Left ventricle hypertrophy,aortic stenosis

     
  37. Yassar Says:
  38. HOCM

     
  39. Anonymous Says:
  40. effusive pericarditis

     
  41. hypertrophic obstructive cardiomyopathy..ecg will show left ventricular strain pattern..

     
  42. Anonymous Says:
  43. we all have given our differentials and definite diagnosis.. can anyone please reveal the correct answers for it..

    thanks in anticipation.

     
  44. Anonymous Says:
  45. hypertrophic obstructed cardiomyopathy...

     
  46. Anonymous Says:
  47. SAM
    AORTIC STENOSIS
    SYSTOLIC MURMUR LOCALISATION OF MURMUR LVH
    ON ECG WE WILL SEE LEFT AXIS DEVIATION AND HIGH R WAVE IN V4V5V6

     
  48. Anonymous Says:
  49. Aortic stenosis with hypertrophy of the left ventricle and episodes of ventricular arrithmia

     
  50. Anonymous Says:
  51. HCM

     
  52. Anonymous Says:
  53. aotic coartation?

     
  54. Anonymous Says:
  55. HOCM

    Dr sadia

     
  56. Waseem Says:
  57. Hypertrophic cardiomyopathy is one of the most common genetically transmited cardiac disease. Jerky pulse and ejection systolic murmur are characteristic of the condition.

     
  58. kenny Says:
  59. This comment has been removed by the author.  
  60. kenny Says:
  61. .LVH (Left Ventricular Hypertrophy)/

    .Tricuspid valve prolapse

    ECG CHANGES:-
    Tall R wave(in V5 or V6)/R+S greater than 35 mm.
    a deep S in V1 or V2.
    If there is significant left ventricular 'strain' then there are also inverted T waves in V5 and V6.
    Possible ST depression.
    QRS may be slightly prolonged.

     
  62. Shehryar Says:
  63. Hypertrophic Cardiomyopathy!!
    Jerky pulses are characteristic of hypertrophic cardiomyopathy

     
  64. Hypertrophic Cardiomyopathy
    Jerky Pulse and SEM are characteristic

     
  65. Anonymous Says:
  66. cardiomiopatia da stenosi aortica con insuff cardiaca
    ecg tall R prec sn , st sliv, onda t neg ,aritmia

     
  67. Anonymous Says:
  68. aortic stenosis _on ecg:LVH

     
  69. Anonymous Says:
  70. congestive heart failure??????????????cardio-thoracic ratio is greater than 50%

     
  71. lucky000005 Says:
  72. boy may b going towards left cardiac failure due to aortic stenosis!! mild pain is due to insufficient oxygenation to myocardium.... patient will have tachy-cardia ..

     
  73. Anonymous Says:
  74. WHAT IS THE CORRECT ANSWER ,PLEASE???

     
  75. Anonymous Says:
  76. right atrial and ventricular hypertrophy
    decreased pulmonary vascularity
    prominent pulmonary conus shadow
    Posssibility of pulomary valvular stenosis

     
  77. A convenient chart is given below to locate the reasons of dyapnoea.

     
  78. Risk factors of dyspnoea

     

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