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Walk the Even Hospital Database by book and chapter — the raw source passages that ground Ask, DDx, and the rest.
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Cardiovascular Medicine Cardiac Effusion and Tamponade Diagnosis Depending on acuity, symptoms may include cardiovascular collapse (aortic dissection) or signs of right HF for chronic pro cesses. Consider diagnosis in patients with risk factors: o metastatic lung and breast cancer (most common cause) . cardiac surgery . viral or bacterial pericarditis . systemic rheumatic disease Physical examination and ECG may reveal: . tachycardia . muffled heart sounds . elevated jugularvenous pressure o pulsus paradoxus . electrical alternans v1 v4 I v2 V5 a\tr y3 \6 Electrical Alternans: Electrical alternans is characterized by alternating amplitude of the ORS complexes in any or all leads. Treatment First line treatment includes pericardiocentesis or surgical drainage plus IV normal saline for hemodl'namically unstable patients. 29