Hi, I am a previously healthy 28 yo female. Two weeks ago, the external jugular on the left side of my neck began to increase in size. It stands out about a centimetre, and extends almost to the jaw line. When I take a deep breath, it goes down, but quickly reaccumulates. It is worse at night, to the point where I am finding it difficult to lie down and sleep. It is not visible in the morning when I am standing, but shows if I sit, lean forward or lay down. I have had a neck ultrasound which showed increased pulsatility throughout my venous system, and an echo which showed mild tricuspid regurgitation, and trivial regurg in the pulmonic and mitral valve. My question is: is it likely that mild trucuspid regurg is enough to produce this effect, and if so, is it anything to be concerned about? Should I see a cardiologist? If there is any obstruction, would it have shown up on the two tests I have mentioned? I am on no medications, have no family history of heart disease. I occasionally get palpitations, otherwise I would say I was asymptomatic except for general fatigue...I do have low iron secondary to dysfunctional uterine bleeding, but my haemoglobin is OK. I feel a bit silly worrying about this, but truthfully I really want to know why this has happened all of a sudden. Any help greatly appreciated!
is it likely that mild trucuspid regurg is enough to produce this effect, and if so, is it anything to be concerned about?
Mild tricuspid regurgitation should not have this effect.
Some people have more prominant neck veins.
Should I see a cardiologist?
That echo report isnt something in itself that a cardiologist needs to evaluate. If your primary doc is comfortable managing you I would stick with him/her.
If there is any obstruction, would it have shown up on the two tests I have mentioned?
I feel a bit silly worrying about this, but truthfully I really want to know why this has happened all of a sudden.
Its your body. No need to feel silly. It may have been there all along and you just now are noticing it or it may be more prominant for any number of non specific reasons. Unless things continue to progress symptom wise, I wouldnt give it too much thought or seek any other evaluation.
Hello. I am a First Year Medical Student. I was given a case to study however i am having a difficulty finding the answers to some of the question. Can someone please help me, i would really appreciate it. Thank You Very Much
A 55-year old man entered the hospital with severe shortness of breath, abodominal distention, and fatigue. His history revealed episodes of chest pain precipitated by exertion and relieved by rest and 5 years ago, was confined in a hospital because of an acute myocardial infarction. In the past 3 years he has had progressive shortness of breath and ankle edema that required treatment with digitalis, diuretics, and vasodilators. Despite the therapy, the patient's symptoms becasme much worse and he would complian of difficulty of breathing even at rest. He is unable to sleep without 4 pillows propping him up, and often wakes up because of acute air hunger.
1. What causes distended neck veins and what is its significance?
2. Describe the surface anatomy of the heart in relation to its borders, great vessels and heart valves.
3. What radiologic features are found on chest radiographs in patients with congestive heart failure?
4. What ate the histologic changes you would expect i the coronary arteries?
5. Branch of which coronary artery is most likely affected?
Thank you again... i would be waiting for anyones reply and insights...
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