Thorax and Heart-Taylor

Question 1

• What is a cardiac tamponade?
• What does pericardial pressure imped?

Answer 1

• Occurs when fluid accumulates between the pericardial sac and the heart in an acute manner. Pericardium is inelastic, pressure begins to rise rapidly within the pericardial sac as fluid accumulates within it acutely.
• Rising pericardial pressure impedes venous return to the heart thus diminishes cardiac output and blood pressure.

Question 2

What are the common causes of cardiac tamponade?

Answer 2

• Most common is blunt and penetrating trauma into one of the chambers. Right ventricle is the most anterior chamber in the heart and is therefore the most injured.
• With the rising pressure resulting in the cardiac tamponade, also the increased pressure in the pericardium may temporarily impede further bleeding allowing the patient to survive longer.

Question 3

What is Beck’s Triad ⭐️ ⭐️ ⭐️

Answer 3

• Detection of some of these signs is difficult, additionally the components of Beck’s triad are present 22-77% of the time.
• Maintain a high index of suspicion, based on the location of the wounds and hypotension.

Question 4

What are the different types of cardiomyopathies?

Answer 4

Question 5

Dilated cardiomyopathy?

Answer 5

Ventricle contracts with less force and becomes progressively dilated (impaired contractility results in dilation), with impaired systolic function (less than 40%).
* Poor contraction, low left ventricular ejection fraction, heart dilates to compensate.

See in alcohol

Question 6

What are the pathos of hypertropic cardiomyopathy?

Answer 6

• Unexplained hypertrophy leads to LV outflow obstruction and impaired diastolic filling
• Impaired diastolic filling leads to pulmonary congestion
• Up to 600,000 affected in the U.S. each year
• Risk of progression to sudden cardiac death warrants early intervention

Question 7

Hypertrophic cardiomyopathy-signs and symptoms?

Answer 7

Question 8

How does hypertrophic cardiomyopathy work?

Answer 8

• Obstructive which affects the mitral valve against the ventricular septum. The mitral valve contacts the large ventricular septum obstructing the flow of blood from the left ventricle of the heart and causing regurgitation of blood back into the left atrium.
• Obstruction to the flow usually causes increase in pressure in heart which is responsible for exercise –limiting symptom of exertional dyspnea.
• Non obstructive hypertrophic cardiomyopathy, the absence of an outflow gradient both at rest and with variety of physiologic and no physiologic maneuvers and drugs. (1/3 of population)

Question 9

What is the clinical finding of hypertrophic cardiomyopathy THAT WE NEED TO KNOW?

Answer 9

Murmur decreases with squatting – increases preload and increases venous return, increasing the preload in the ventricle decreases the septal hypertrophy obstruction and the murmur becomes softer.

Question 10

What is teh patho features of restrictive cardiomyopathy? + causes?

Answer 10

Question 11

What are the EKG of MI?

Answer 11

Question 12

What enzymes are important for MI?

Answer 12

Question 13

What is flail chest?

Answer 13

Flail chest is when three or more adjacent ribs are fractured in at least two places which causes a paradoxical motion of the chest wall.