SOB in CVS

Question 1

left ventricular failure

Answer 1

dyspnoea and fatigue
(on exertion // at rest)
paroxysmal nocturnal dyspnoea
LVEF <50%

Question 2

constrictive pericarditis

Answer 2

uncommon
progressive fibrosis and calcification of the pericardium

can be idiopathic, a complication of acute pericarditis, following radiation exposure to the chest

gradually worsening signs of fluid overload (SOB, bilateral basal crepitations, pitting ankle oedema)

y defend in VP (friedreich’s sign) and pericardial knock in early diasotole

Kussmal sign (parodical rise in JP during inspiration)

tx: pericardectomy

Question 3

cardiac tamponade

Answer 3

accumulation of large volume of pericardial fluid / blood within the pericardium

Beck’s triad- hypotension, raised JVP, muffled heart sounds

pulses paradoxus (Exaggerated fall in BP during inspiration)

Kussmal sign

medical emergency!
mx: pericardiocentesis