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  #1  
Old 07-03-2011
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Heart coarse scratchy sounds are heard throughout cardiac cycle--next step in management?

a 49 y old f present with chest pain presents with inspiration and improves when she bends forward and holds her breath.bp is 140/90.on auscultation coarse scratchy sound heard throughout cardiac cycle.ecg showst wave inversion.most appropriate next step in management?
a.iv heparin
b.oral prednisone
c.fibrinolytics
d.oral aspirin
e.primary angioplasty
f.chest radiograph
g.echocardiogram
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  #2  
Old 07-03-2011
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i would go with D
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Old 07-03-2011
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Echocardiography
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Old 07-04-2011
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Originally Posted by confident View Post
a 49 y old f present with chest pain presents with inspiration and improves when she bends forward and holds her breath.bp is 140/90.on auscultation coarse scratchy sound heard throughout cardiac cycle.ecg showst wave inversion.most appropriate next step in management?
a.iv heparin
b.oral prednisone
c.fibrinolytics
d.oral aspirin
e.primary angioplasty
f.chest radiograph
g.echocardiogram
answer is d.for benign pericarditis anti-inflammatory is the choice.inflammation and roughening of pericardial sac produce pericardial rub through out the cycle.its triphasic i,e heard in ventricular systole,diastole and atrial systole. sound best heard at lower left sternal border with patient leaning forward.ecg finding is st elevation and pr depression early followed by t wave inversion.
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Old 07-04-2011
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Originally Posted by amirh899 View Post
Echocardiography
i thought ans to be echo to rule out pericardial effusion and to know its complicated or uncomplicated pericardial effusion...but i think in benign coarse just give nsaid and later do echo
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Old 07-07-2011
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Quote:
Originally Posted by confident View Post
answer is d.for benign pericarditis anti-inflammatory is the choice.inflammation and roughening of pericardial sac produce pericardial rub through out the cycle.its triphasic i,e heard in ventricular systole,diastole and atrial systole. sound best heard at lower left sternal border with patient leaning forward.ecg finding is st elevation and pr depression early followed by t wave inversion.
But i still think it shuld be echo.........even if its benign.......u have to have a diagnosis........what is the source of the question btw?
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Old 07-07-2011
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But i still think it shuld be echo.........even if its benign.......u have to have a diagnosis........what is the source of the question btw?

I too dont know the source of question just few printed question given by my friend.
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Old 07-07-2011
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I too dont know the source of question just few printed question given by my friend.
hmmmm.............doesnt sound like an authentic one.........never mind though . I wuld still go for echo then.......u never start sumone on a treatment on a suspicion of pericarditis widout havin a definitive or near definitive daignosis in clinical setting...esp if the organ involved is Heart.
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Old 07-07-2011
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Originally Posted by tangled View Post
hmmmm.............doesnt sound like an authentic one.........never mind though . I wuld still go for echo then.......u never start sumone on a treatment on a suspicion of pericarditis widout havin a definitive or near definitive daignosis in clinical setting...esp if the organ involved is Heart.

hi tangled...

yea that is correct echo i used to think similarly to rule out if it is complicated or uncomplicated pericardial effusion( cardiac tamponade)....
but no harm in giving nasid before to relieve pain before starting diagnostic work up....I dont know how to add link so please go and check post acute pericardities with mild effusion threa in this forum..similar incidence is discussed well there.thanks
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  #10  
Old 07-07-2011
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Originally Posted by confident View Post
hi tangled...

yea that is correct echo i used to think similarly to rule out if it is complicated or uncomplicated pericardial effusion( cardiac tamponade)....
but no harm in giving nasid before to relieve pain before starting diagnostic work up....I dont know how to add link so please go and check post acute pericardities with mild effusion threa in this forum..similar incidence is discussed well there.thanks
Now u r talking....................Ill surely check......makes sense
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