Remove ACE Inhibitor Remove Coronary Artery Disease Remove Echocardiogram
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Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

MIBHS

Heart Valve Disease If one or more heart valves are not functioning correctly, it can cause blood to flow backward, putting extra pressure on the heart, which may cause it to expand to compensate for the inefficiency. This may result in ischemia (lack of oxygen to the heart muscle), causing parts of the heart to weaken and enlarge.

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A man in his 70s with chest pain during a bike ride

Dr. Smith's ECG Blog

The patient stated he had a long history of well-controlled hypertension for which he was compliant with his ACE-inhibitor. He was taken emergently to the cardiac catheterization lab and found to have multi-vessel coronary artery disease with a near-occlusive culprit lesion in the RCA, possibly reperfused.

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

Hospital Course The patient was taken emergently to the cath lab which did not reveal any significant coronary artery disease, but she was noted to have reduced EF consistent with Takotsubo cardiomyopathy. Here is the cath report: Echocardiogram: There is severe hypokinesis of entire LV apex and apical segment of all the walls.

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