This may give the heart an enlarged appearance when, in fact, it is not enlarged. Based on the clinical information thus far, it is difficult to determine with certainty the magnitude of congestive heart failure, if any. An echocardiogram would be useful in this situation. A stat echocardiogram is performed. It shows slight enlargement of the left atrium and left ventricle.
Contractility is normal.
This study was able to rule out cardiogenic causes of congestive heart failure. It is unclear what is responsible for her acute deterioration. Her anemia may be due to hemolysis or hemorrhage. However, it is unclear whether this has worsened acutely, or whether this has occurred slowly. Regardless, she is anemic and in failure.