Now for the real quiz. What is seen?Diagnosis? #MedTwitter #MedStudents #MedStudentTwitter #CardioTwitter
@HaryaxPathak @aproudempath @dynorphin_ @xMissChocoholic @vedvyazz
Tamponade. Arterial tracing showing significant respiratory variation. Pericardiocentesis done and 400ml removed. This is the tracing after removing the fluid.
Normal arterial waveform without respiratory variation after tapping the pericardial fluid.
https://www.ncbi.nlm.nih.gov/books/NBK431090/
Cardiac Tamponade

Cardiac tamponade is a medical or traumatic emergency that happens when enough fluid accumulates in the pericardial sac compressing the heart and leading to a decrease in cardiac output and shock....

https://www.ncbi.nlm.nih.gov/books/NBK431090/
An excellent thread on Pulsus Paradoxus and why it's a misnomer! https://twitter.com/jackpenner/status/1253423178895904780
https://www.ncbi.nlm.nih.gov/books/NBK482292/
Pulsus Paradoxus

Pulsus paradoxus refers to an exaggerated fall in a patient’s blood pressure during inspiration by greater than 10 mm Hg. Pulsus paradoxus results from alterations in the mechanical forces imposed on...

https://www.ncbi.nlm.nih.gov/books/NBK482292/
Take home message - Whenever BP is not responding to inotropes in adequate doses and there is respiratory variation in pulse oximeter or arterial pressure waveforms, ask for an echo to rule out Cardiac Tamponade. If confirmed - urgent pericardiocentesis without delay.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401877/
Echocardiographic Evaluation of Pericardial Effusion and Cardiac Tamponade

Pericardial effusion (PEff) is defined by an increase in the physiological amount of fluid within the pericardial space. It can appear following different medical conditions, mainly related to...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401877/
You can follow @DrDeepakKrishn1.
Tip: mention @twtextapp on a Twitter thread with the keyword “unroll” to get a link to it.

Latest Threads Unrolled:
Those who think consciousness raising & movement building are disconnected, or even a distraction from electoral politics have not paid attention to the history of social change.In this thread, we
Read more
The 2020s will be known as the Remote Work decadeA few predictions of what is likely to emerge[ a thread ] Third Space: Office and Working from Home will
Read more
1/29: Have you ever had a concept explained to you that helps frame complex issues you’ve been wrestling with and opens your eyes to new possibilities? A concept that I
Read more
By continuing to use the site, you are consenting to the use of cookies as explained in our Cookie Policy to improve your experience.