doc649
Forum Junior
Topics: 18
Posts: 61
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6. A 72-year-old man with a history of coronary
artery disease and hypertension is hospitalizedafter suffering a myocardial infarction 5 days
ago. He suddenly complains of severe chest
pain. His blood pressure is 90/60 mm Hg and
his heart rate is 65/min. Auscultation reveals
no murmurs or rubs. An ECG reveals sinus
rhythm with an acute ST segment elevation in
the anteroseptal area. Urgent bedside echocardiography
showed anteroseptal, lateral, and
apical akinesis, mild left ventricular systolic
dysfunction, and severe pericardial effusion.
Within 20 minutes he is unconscious with undetectable
pulses and blood pressure. What is
the most likely cause of the patient’s sudden
decompensation?
(A) Free wall rupture
(B) Left ventricular thrombus
(C) Mitral regurgitation
(D) Pericarditis
(E) Ventricular septal rupture
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| doc649
Forum Junior
Topics: 18
Posts: 61
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My ans was Aaa
not sure though.........
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| drshvetasm
Forum Elite
Topics: 22
Posts: 278
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yeah...sounds like free wall rupture to me too. especially coz of the MI 5 days ago...the pericardial effusion makes this a stronger bet.
akinesis wud also point to ventricular thrombus but that wouldnt expain the pericardial effusion...
is the answer given as something other than a?
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| nyimalay
Forum Elite
Topics: 9
Posts: 280
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I would go for A too.
5 days post MI, pericardial fluids and shock.
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| doc649
Forum Junior
Topics: 18
Posts: 61
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i actually dont have the answer.....so need your help to solve it............
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| hir
Forum Elite
Topics: 2
Posts: 344
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me too......A
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| yogesh
Forum Newbie
Topics: 5
Posts: 56
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Only A and D give Effusion. Pt decomensated so drastically, so it's A. D takes hours.
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| Ivonne
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AAAAAAAAAAA
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| guangyu
Forum Elite
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a
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| inkspot
Forum Guru
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A .
shock + 5th post MI day. and no murmur
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| Pioglitazone
Forum Newbie
Topics: 0
Posts: 15
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definitely A
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