J.P., a 56-year-old man, developed a severe viral infection with fatigue, fever, and myalgia. Although he
recovered from the acute episode, J.P. never quite regained his normal activity level. Six months later,
J.P.
continued to find it difficult to work a 10-hour day as a brick mason, so he returned to his physician.
Diagnostic studies revealed heart failure related to postviral cardiomyopathy. After medical management
with metoprolol (Toprol XL) and furosemide (Lasix), his condition stabilized and he returned to work.
After several months, J.P.'s condition began to deteriorate and his work attendance became erratic.
Sixteen months later he is being admitted complaining of dyspnea with minimal exertion, fatigue, orthopnea, chest pain, anorexia, and feelings of abdominal fullness. He has 2+ peripheral edema and is diaphoretic. Further studies reveal that J.P. has cardiac dilation, moderate to gross ventricular hypertrophy, and
a systolic ejection fraction of 17%, consistent with severe congestive cardiomyopathy. Because J.P.'s only
other health problem is mild hypertension, a heart transplant evaluation is recommended. J.P. and his
wife discuss his prognosis, and he agrees to an evaluation for possible heart transplantation.
If J.P. is accepted for cardiac transplantation, what data will be collected in addition to his
past medical history, current diagnostic findings, and cardiac evaluation?
Pulmonary, renal, and infectious disease evaluation; laboratory data, including hematologic,
immunologic, biochemical, virologic, and microbiologic evaluation; evaluation for other chronic
illnesses; psychological evaluation; and potential for compliance with medical appointments, dietary
restrictions, and medication regimen.
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