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Old 08-29-2013
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Heart Pericarditis versus Cardiac Temponade

Hello,


If a question gives you information about the heart and you must give a diagnosis between pericarditis and cardiac tamponade, which one to choose? And why?



Also does pulsus paradoxus occur with pericarditis or with cardiac tamponade?
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Old 08-29-2013
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pericarditis pain with respiration that is relieved by leaning forward
sometimes friction rub is the clue, EKG-pr depression and ST elevation in all leads

cardiac tamponade-hypotension, tachycardia, kussmauls sign, distant heart sounds, pulsus paradoxus
EKG-electrical alterans
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Cardiac tamponade involves:
1. Beck triad - which is hypotension, increase JVP, and Muffler heart sound.
2. Usually happens after MI, around 5 - 10 days in which macrophages comes in and causes free wall rupture.

Pericarditis involves:
1. Pain during inspiration.
2. Pain is release during exhale and leaning forward.
3. There's friction rub.
4. Occurs after MI and that's call Dresser syndrome.
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Default cardiac tamponade & pericarditis

Quote:
Originally Posted by Doctor Ali View Post
Cardiac tamponade involves:
1. Beck triad - which is hypotension, increase JVP, and Muffler heart sound.
2. Usually happens after MI, around 5 - 10 days in which macrophages comes in and causes free wall rupture.

Pericarditis involves:
1. Pain during inspiration.
2. Pain is release during exhale and leaning forward.
3. There's friction rub.
4. Occurs after MI and that's call Dresser syndrome.
Well all comparison are given nicely ,but normal portable Echocardiograpgy may show collapsing R.V & R .A in case of temponade
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Old 08-31-2013
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Quote:
Originally Posted by jazzygirl View Post
Well all comparison are given nicely ,but normal portable Echocardiograpgy may show collapsing R.V & R .A in case of temponade
That's true. That's how free wall rupture happens.
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Old 09-02-2013
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A 42-year-old woman with a history of active breast cancer presents with acutely worsening dyspnea. Physical exam reveals tachycardia, hypotension, elevated jugular venous pressure, and distant heart sounds. An EKG shows electrical alternans. Pulsus paradoxus is performed and is 20 mm Hg. A chest x-ray reveals a large cardiac silhouette. A two-dimensional echocardiogram confirms a large pericardial effusion with tamponade physiology. All the following are true concerning cardiac tamponade, except:


a) Pulsus paradoxus can be seen in other conditions, such as chronic obstructive pulmonary disease (COPD).
b) Cardiac catheterization will show diastolic equilibration of pressures within the heart.
c) The most specific echocardiographic finding of tamponade is LV collapse.
d) Mechanical ventilation with positive airway pressure should be avoided in patients with tamponade, because this further reduces cardiac output.
e) Electrical alternans is an EKG beat-to-beat change in the QRS axis secondary to swinging of the heart within the fluid-filled pericardium


i thought it wil be good idea to discuss it here what d you think guys?
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A 50-year-old man is brought to the emergency department complaining of light-headedness. He has a history of lung cancer, which was diagnosed a month ago and found to be widely metastatic to the bone and pericardium. On physical examination, his blood pressure is 70/40 mm Hg, and his pulse is 100/min. His heart sounds are distant and soft. His ECG demonstrates low voltage, and electrical alternans is present. A chest x-ray film shows that the cardiac silhouette has a "water bottle" appearance.Which of the following is the most appropriate intervention in this patient?
A. Beta-blockers
B. Nonsteroidal anti-inflammatory drugs
C. Steroids
D. Pericardiocentesis
E. Cardiac catheterization

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sory guys' _ its step-2 qs(i diin know) i wos Google'ing Constrictive pericarditis n Jvp so came across em'

any way its Good for concept though'
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Quote:
Originally Posted by vita86 View Post

A 50-year-old man is brought to the emergency department complaining of light-headedness. He has a history of lung cancer, which was diagnosed a month ago and found to be widely metastatic to the bone and pericardium. On physical examination, his blood pressure is 70/40 mm Hg, and his pulse is 100/min. His heart sounds are distant and soft. His ECG demonstrates low voltage, and electrical alternans is present. A chest x-ray film shows that the cardiac silhouette has a "water bottle" appearance.Which of the following is the most appropriate intervention in this patient?
A. Beta-blockers
B. Nonsteroidal anti-inflammatory drugs
C. Steroids
D. Pericardiocentesis
E. Cardiac catheterization

My answer is D.
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Quote:
Originally Posted by vita86 View Post
sory guys' _ its step-2 qs(i diin know) i wos Google'ing Constrictive pericarditis n Jvp so came across em'

any way its Good for concept though'
Actually, it is step 1 question.
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