cardiac temporade

Question 1

pathology

Answer 1

• pericarditis causes too much exudation
• leads to inc pressure
• compressed the heart
• impairs ventricular filling
• reduces cardiac output

plus effusion is always associated:
- RV expands and pushes into LV - making it smaller

Question 2

symptoms

Answer 2

all pericardial symptoms +
- SOB
- tachycardia
- confusion
- chest pain
- abdominal pain

Question 3

diagnosis

Answer 3

• ECG - electrical alternations
• tranthoracic echo - see fluid in the area
• chest X-ray - big globular heart

Question 4

signs

Answer 4

becks triad:
- raised jugular venous pressure
- hypotension
- muffled heart sounds

• hypotension and shock

pulsus paradoxus - reduction in systolic blood pressure upon inspiration ( - 10mmHg)

Question 5

ECG

Answer 5

• alternating QRS size
• lots of beats - higher than normal HR
• shorter voltage

Question 6

treatment / management

Answer 6

urgent pericardiocentesis:
- sticking a needle to frain fluid - first line if not haemodynamically unstable

• needle inserted between xiphisternum and left costal margin and directed towards left shoulder

if patient haemodynamically stable - carefully observe with echo and give IV fluid treatment to maintain ventricular filling