A 61-Year-Old Man With Shortness of Breath, Ascites, and Lower Extremity Edema.
A 61-year-old man presented with an 18-month history of progressive shortness of breath on exertion, fatigue, worsening bilateral lower extremity edema, abdominal swelling, and increased assistance with activities of daily living. Pertinent past medical history included right-sided pneumonia secondary to Streptococcus pneumoniae that was complicated by empyema, requiring right-sided video-assisted thoracoscopic surgery with decortication 2 years earlier. He had a negative cardiac history, no recent travel in the last 3 years, and no known exposure to tuberculosis. His medications included aspirin and daily furosemide. His symptoms appeared to be refractory to diuretic therapy. Previous workup 6 months earlier included an echocardiography (ECHO) showing enlarged left and right atria with a normal ejection fraction, and a catheterization of the left side of the heart with reported normal left ventricular function and unobstructed coronary arteries.
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL. Electronic address: aliataya@gmail.com.
Ali
A
Ataya
College of Medicine, and the College of Pharmacy, University of Florida, Gainesville, FL.
Jessica M
JM
Cope
Adult Congenital Heart Disease Program, Congenital Heart Center, University of Florida, Gainesville, FL.
Diego
D
Moguillansky
Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, FL.
Tiago N
TN
Machuca
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL.
Hassan
H
Alnuaimat
D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D016724:Empyema, Pleural / Q000150:complications* / Q000382:microbiology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D010492:Pericardiectomy / Q000379:methods*; D010494:Pericarditis, Constrictive / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D010496:Pericardium / Q000473:pathology / Q000601:surgery; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D016896:Treatment Outcome