Grand Round Case - A Reversible Form of Cardiomyopathy

A 30 years old female, mother of a three-year-old child, presented with breathlessness and chest pain for four days and orthopnoea for last two days. She had no past history of cardiac, renal or thyroid disease. On examination, she was orthopnoeic, with a respiratory rate of 44/minute and pulse rate of 150/minute, which was regular in rhythm. The blood pressure was 110/70mmHg. The jugular venous pressure was raised. there was no pallor, cyanosis or oedema. The hyperdynamic apex impulse was situated in the 6^thintercostal space 2.5 cm lateral to the left midclavicular line. Chest auscultation revealed bilateral basal crepitations and S3 gallop rhythm. There was no cardiac murmur or pericardial rub.