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Inflammatory Structural heart disorders #2 (Pericardial effusion…
Inflammatory Structural heart disorders #2
Pericardial effusion
lose cardiac output
Tachycardia and low BP
muffled heart tones
not able to expand and fill with blood
heart being compressed by fluid
treatment
pericardiocentesis
blind stick aiming towards heart or can do ultrasound guided
caused by trauma, infective endocarditis
70-100cc of fluid
as pull fluid pulled out, should see increase in BP and decrease in infusion
pericardial window
surgical small cup of flap
Aortic Aneurysms
weakening of the arterial walls
conservative treatment
less that 4cm, blood pressure control
aggressive treatment
5cm or more of ruptures, pt dies
can go through cath lab and and put big stent to take pressure off anterior walls
risk - smaller arteries wont get fed due to stents and get necrotic areas,
bowel sounds very important and distal pulses
diagnostic studies
ultrasound or ct wit contrast
endovascular graft
Aortic Dissection
Interior lining rips creating false lumen
risk - rip extends to renal or to carotic
S/S ripping back pain, intense pain, HTN
can happen in any location
decrease BP, nipride or cardine drip, BP q 5-15 min
consertive treatment
aggressive BP management
aggressive treatment
go in through open chest or cath lab and put in stent in the aorta
very specialized procedure, patient usually gets shipped out
diagnostic study
ct with contrast
worried about feeder arteries