WBR0428
| Author | [[PageAuthor::Rim Halaby, M.D. [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pathology |
| Sub Category | SubCategory::Cardiology |
| Prompt | [[Prompt::A 57 year old male patient presents to the emergency deparment with severe acute-onset chest pain. The patient is previously healthy with a history of respiratoy illness 6 days prior to presentation. On physical examination, the patient’s vital signs show a temperature of 37 degrees C (98.6 degrees F), heart rate of 112 beats per minute, and blood pressure measuring 80/50 mmHg. On physical examination, the physician notes that there is marked jugular venous distension (JVD), and weakness of peripheral radial pulse upon inspiration. Which of the following is the most important factor in determining the clinical presentation of this patient’s condition?]] |
| Answer A | AnswerA:: |
| Answer A Explanation | AnswerAExp:: |
| Answer B | AnswerB:: |
| Answer B Explanation | AnswerBExp:: |
| Answer C | AnswerC:: |
| Answer C Explanation | AnswerCExp:: |
| Answer D | AnswerD:: |
| Answer D Explanation | AnswerDExp:: |
| Answer E | AnswerE:: |
| Answer E Explanation | AnswerEExp:: |
| Right Answer | RightAnswer::A |
| Explanation | [[Explanation::Cardiac tamponade is a potentially fatal compression of the heart due to accumulation of pericardial fluid, pus, blood, clots, or even gas. Cardiac tamponade can be a complication of a ruptured myocardial infarction, a recent cardiothoracic procedure, tuberculous infection, neoplasia, uremia, or pericarditis. The accumulation can be due to effusion, trauma, or cardiac muscle rupture. Tamponade is characterized by several physiological changes that alter diagnosis and treatment. The primary abnormality of cardiac tamponade is the compression of heart chambers due to the elevated intrapericardial pressure.
At first, the pericardium stretches normally with time. However, the pericardium then becomes inextensible, and the heart chambers will then become affected by the increasing pericardial pressure and heart chambers will progressively become smaller and mean diastolic pericardial and chamber pressures will ultimately equalize. The rate of fluid accumulation and the compensatory cardiac mechanisms are two important factors that determine clinical presentations of cardiac tamponade. Cardiac tamponade is a potentially fatal compression of the heart due to accumulation of pericardial fluid, pus, blood, clots, or even gas. Cardiac tamponade can be a complication of a ruptured myocardial infarction, a recent cardiothoracic procedure, tuberculous infection, neoplasia, uremia, or pericarditis. The accumulation can be due to effusion, trauma, or cardiac muscle rupture. Tamponade is characterized by several physiological changes that alter diagnosis and treatment. The primary abnormality of cardiac tamponade is the compression of heart chambers due to the elevated intrapericardial pressure.
At first, the pericardium stretches normally with time. However, the pericardium then becomes inextensible, and the heart chambers will then become affected by the increasing pericardial pressure and heart chambers will progressively become smaller and mean diastolic pericardial and chamber pressures will ultimately equalize. The rate of fluid accumulation and the compensatory cardiac mechanisms are two important factors that determine clinical presentations of cardiac tamponade. |
| Approved | Approved::No |
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| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |