Today's case was an interesting presentation of a 51 year old Korean male presenting with new onset congestive heart failure. In this case, dialted cardiomyopathy was diagnosed and untreated hypertension was felt to be the most likely cause. The significant elevation in liver enzymes in this case was striking, somewhat above what would be expected with congestive hepatopathy. This Cleveland Clinic Journal review article has a nice summary of the differential and workup of this disease.
An interesting historical footnote is an outbreak of cardiomyopathy in Canada and the US Midwest associated with cobalt containing beer. Cobalt had been added to certain brands of beer as a foam stabilizer and was felt to be non-toxic. Apparently they did not consider the "volume" consumed by certain Canucks and Midwesterners, especially during hockey season... This was favorite challenge bowl fodder where I trained.
As for heart failure management in general, the ACP In the Clinic series has an excellent review of the topic linked here. The In The Clinic site also have slide sets of their topics that you can use for teaching interns / students / etc. Make use of it!
Review of topics covered in morning report, M&m, and core conferences with links to supplemental reading material.
Subscribe
Posts
Comments
No comments:
Post a Comment