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A 54-Year-Old Man Comes to the Emergency Department Due to Severe

question 683

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A 54-year-old man comes to the emergency department due to severe shortness of breath and palpitations.  During initial assessment, pulse oximetry shows 83%.  Diffuse, bilateral crackles are heard on lung auscultation.  Chest x-ray is consistent with pulmonary edema.  ECG shows atrial fibrillation with rapid ventricular response.  The patient dies despite appropriate medical care.  Autopsy is performed and gross examination of the heart is shown below. A 54-year-old man comes to the emergency department due to severe shortness of breath and palpitations.  During initial assessment, pulse oximetry shows 83%.  Diffuse, bilateral crackles are heard on lung auscultation.  Chest x-ray is consistent with pulmonary edema.  ECG shows atrial fibrillation with rapid ventricular response.  The patient dies despite appropriate medical care.  Autopsy is performed and gross examination of the heart is shown below.   Histologic examination of the myocardial tissue reveals thick myocardial fibers with large, hyperchromatic nuclei as well as mild interstitial fibrosis.  Which of the following is the most likely diagnosis? A) Cardiac amyloidosis B) Hypertensive heart disease C) Hypertrophic cardiomyopathy D) Mitral stenosis E) Pulmonary arterial hypertension Histologic examination of the myocardial tissue reveals thick myocardial fibers with large, hyperchromatic nuclei as well as mild interstitial fibrosis.  Which of the following is the most likely diagnosis?


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