Clinical question of the week: nausea, vomiting and generalised weakness

A 36 year old Asian male has a chief complaint of nausea/vomiting and generalized weakness. He also endorses muscle cramps  and a history of intermittent fevers at home. He is a non-smoker, denies excess alcohol use, and denies substance use.   He has a past medical history of:   • Extra-pulmonary TB    • HIV diagnosed September 2014     On examination of the paient:   • The only physical exam findings of significance are mild tachycardia (HR-110s-120s)  and mild hypoxemia (SpO2-92-93%)     Labs:   • Only abnormal test result is creatinine of 1.4     EKG revealed:       Echo was ordered, which revealed:             Questions-   1. What is the diagnosis?   2. How best to treat this?   3. Is there any role for surgery?
Source: Doc2Doc BMJ Cardiology - Category: Cardiology Authors: Source Type: forums