1B

Question 1

Cardiac Tamponade

Answer 1

Build-up of fluid in the pericardium resulting resulting in inadequate beating of the heart

Question 2

Causes of cardiac tamponade

Answer 2

Trauma to chest
MI
Aortic dissection
Chronic hypothyroidism
Lung/breast cancer
Chronic inflammation

Question 3

Layers of the heart (outside -> inside)

Answer 3

Fibrous pericardium
Parietal pericardium
Pericardial cavity
Visceral Pericardium
Myocardium
Endocardium

Question 4

Pathophysiology of cardiac tamponade

Answer 4

increase in serous fluid in the pericardial cavity, causing inefficient contraction of the heart leading to inefficient filling of ventricles and a decrease in CO

Question 5

Risk factor for Cardiac tamponade

Answer 5

MI
Cancers - lung and breast
Heart disease

Question 6

Signs and symptoms of Cardiac Tamponade

Answer 6

Beck’s Triad: Hypotension, muffled heart sound and distended jugular veins
Syncope
Coughing
Tachycardia
Dyspnoea

Question 7

What is Beck’s triad

Answer 7

Sign of Cardiac Tamponade:
hypotension, distended jugular vein , muffled heart sounds

Question 8

Examination of cardiac tamponade

Answer 8

CVS examination: muffled heart sounds and distended jugular veins
pulsus paradoxus (drop in systolic bp during inhalation)
Resp examination

Question 9

DDx cardiac tamponade

Answer 9

Large pleural effusion
Pneumothorax
PE
Cardiogenic shock
Constrictive pericarditis

Question 10

investigations for cardiac tamponade

Answer 10

Echo: observe excess fluid, swinging heart, pressure of all heart chambers equal

ECG: tachycardia, Low QRS voltage, electrical alternans (QRS have different heights)

Question 11

Management for cardiac tamponade

Answer 11

Medical emergency
Percardiocentesis
CXR and Echo in 24 hrs and one month later
treatment to ensure no further fluid buildup
treat the underlying cause/disease

Question 12

complications of cardiac tamponade

Answer 12

death