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Old 06-20-2011
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Heart Tearing chest pain in a Fibrillin defective patient

A 18 year old pregnant female with an autosomal dominant disease caused by a mutation in the gene that encodes the protein, fibrillin, reports to the emergency department complaining of substernal tearing chest pain and light headedness. The patientís vitals are: Temperature 98.7 F, Pulse 160 bpm, Blood Pressure 96/38, and respiratory rate of 26. On physical exam you notice faint heart sounds and bulging neck veins. The nurse tells you that there is a difference in blood pressure of 18 mmHg between inspiration and expiration. What crisis is this woman most likely suffering from?

A - Pulmonary embolism
B - Cardiac tamponade
C - Myocardial infarction
D - Acute pericarditis
E - Transient ischemic attack
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Old 06-20-2011
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fibrillin is the "F" in Marfan

B) Cardiac tamponade
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yes it is B
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Marfanís disease is a connective tissue disease involving fibrillin. 2) Patientís with Marfanís disease are susceptible to aortic dissection. 3) Aotic dissections can lead to Cardiac Tamponade which is recognized by Beckís Triad: hypotension, muffled heart sounds, and jugular venous distention.
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Old 06-20-2011
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B. cardiac temponade in pt of marfan's due to dissecting aneurysm, in addition to beck's triad , there is a difference in BP on inspiraton n expiration of more than 10
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Cardiovascular-, Pathology-, Step-1-Questions, Syndromes-Acronyms

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