PATIENT: Claudia Paton 13791
HISTORY: 12yo DSH. tachycardia, murmur (systolic), tachypnoea, hyperpnoea. Bloods largely unremarkable, t4 normal
the findings are compatible with restrictive cardiomyopathy with marked biatrial enlargement and thoracic radiography is warranted to assess the degree of congestive failure present.
Comments: the patient is very distressed and quite dyspnoeic when laid in lateral recumbency, with open-mouth breathing and subsequent yowling / twisting / thrashing. Exam therefore delayed and subsequently performed in slightly tilted sternal recumbency with stroking and no other restraint; during this the patient remained calm and did not move, although respirations are still increased from previously. 0.2ml dimazon administered i/m once subjective assessment made – which is that there is marked biatrial enlargement here consistent with the suspected congestive failure. The ventricles appear to have normal dimensions although systolic function is subjectively slightly reduced.
LVFW ED 5mm
not performed due to altered alignment as described above
mild mitral and tricuspid regurgitation
MITRAL INFLOW: E and A merged 1.2m/s. Mitral Regurgitation? yes not measured due to alignment
AORTIC OUTFLOW: Max Velocity 1m/s. Aortic Insufficiency? no
TRICUSPID INFLOW: Tricuspid Insufficiency? yes not measured due to alignment
PULMONIC OUTFLOW Max Velocity 1m/s. Pulmonic Insufficiency? no