Myocardial Disease II

Cardiovascular System

{"ops":[{"insert":"A 58-year-old man comes to the physician because of persistent nonproductive cough for 2 months. He has not had orthopnea or paroxysmal nocturnal dyspnea. He has not had chest pain. He has hypertension treated with ramipril for the past 3 months. He does not smoke. His pulse is 100\/min and regular, respirations are 20\/min, and blood pressure is 170\/75 mm Hg. Cardiac examination shows a displaced apex beat. An ECG shows left ventricular hypertrophy. Ramipril is ceased. The most appropriate next step in management is administration of which of the following?"},{"insert":"\n"}]}














{"ops":[{"insert":"EHARA S, SHIRAI N, MATSUMOTO K, OKUYAMA T, MATSUMURA Y, YOSHIKAWA J, YOSHIYAMA M. The clinical value of apex beat and electrocardiography for the detection of left ventricular hypertrophy from the standpoint of the distance factors from the heart to the chest wall: a multislice CT study. Hypertens Res [online] 2011 Sep, 34(9):1004-10 [viewed 20 July 2019] Available from: http:\/\/\/pubmed\/21654756"},{"insert":"\n","attributes":{"list":"ordered"}},{"insert":"KATHOLI RE, COURI DM. Left ventricular hypertrophy: major risk factor in patients with hypertension: update and practical clinical applications. Int J Hypertens [online] 2011:495349 [viewed 20 July 2019] Available from: http:\/\/\/pubmed\/21755036"},{"insert":"\n","attributes":{"list":"ordered"}}]}

Want to continue playing?

Open your Clinical Odyssey account today.

Enjoy unlimited access to 600+ simulations.
Safely improve your skills, anytime and anywhere.
Get answers to your follow-up questions from practicing physicians.