Rosh Internal Medicine Boost Practice Exam

A 38-year-old woman with dyspnea, fever, and elevated cardiac troponin is most likely suffering from which condition?

1. Endocarditis

2. Myocardial infarction

3. Myocarditis

4. Pneumonia

The correct answer is: Myocarditis

The clinical presentation of dyspnea, fever, and elevated cardiac troponin levels suggests a condition that affects the myocardium and is associated with systemic inflammatory response. Myocarditis is characterized by inflammation of the heart muscle, which can lead to symptoms such as dyspnea due to impaired cardiac function and involvement of the respiratory system. The presence of fever indicates a potential infectious or inflammatory process, which aligns with myocarditis, particularly when caused by viral infections. Elevation of cardiac troponin in this context supports damage to the cardiac muscle, which is a hallmark of myocarditis as inflammation can result in myocardial cell injury and necrosis. The combination of these signs and symptoms points more towards myocarditis rather than infections of other structures such as endocarditis or pneumonia. In summary, the presentation of dyspnea, fever, and elevated cardiac troponin is most closely associated with myocarditis due to the inflammatory nature of the condition affecting both the heart and possibly the systemic response.