AIDS and Pneumocystis Pneumonia
A 34-year-old woman with AIDS and a history of Pneumocystis pneumonia presents with shortness of breath and hemoptysis. She is hypoxic and hypotensive on presentation. See Figures 13-1 and 13-2.
 Figure 13-1. |
 Figure 13-2. |
 Figure 13-3. |
 Figure 13-4. |
QUESTION 1. The following is true except:
A. The patient has marked right ventricular (RV) dilatation with hypertrophy
B. The patient has evidence of RV pressure overload
C. The patient has a moderate pericardial effusion
D. All are correct
View Answer
ANSWER 1: D. The images demonstrate a markedly enlarged right ventricle with severe RV hypertrophy. There is flattening of the interventricular septum in systole consistent with right ventricular (RV) pressure overload. With RV volume overload, the septum would be flattened only in diastole. The left ventricular (LV) cavity is small, and there is a moderate pericardial effusion.
 Figure 13-5. |
 Figure 13-6. |
 Figure 13-7. |
QUESTION 2. Based on the echocardiogram images in Figures 13-3, 13-4 and 13-5, the following statement is true about the patient’s pulmonary hypertension:
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