smitha
Forum Elite
Topics: 53
Posts: 236
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A 68 yo man admitted to ICU for chest pain & ECG consistent with an Acute inf.wall MI.Chest pain resolved & he has been stable since a day. Suddenly his BP drops from 130/90 to70/50 mm Hg.The man denies chest pain but he is somewat confused.
VS: T…98.6, BP….70/50, P….40/min. Phisical exam shows cannon”a” waves.Chest clear bilat., CVS exam…..2/6 systolic murmur. Abdomen benign. Pt. Confused as to time, place but otherwise neuro exam in nonfocal.
Wat’s ur most probable diagnosis?
Hypovolemia
Cardiogenic shock from exension of MI
Valvular or chorde tendinae rupture
Papillary ms. Rupture
Complete hrt. Block
Sinus bradycardia
Ventricular rupture
VSD.
Wat’s the initial t/t for this pt? Wat is the definitive t/t for this pt.?
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| Delmar
Forum Senior
Topics: 24
Posts: 156
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The keyword is "cannon waves"= complete heart block
in such a case pt in icu + developed CHB ....pacemaker would be choice number 1
___________________
VENI VIDI VICI
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| smitha
Forum Elite
Topics: 53
Posts: 236
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THat's PEEEEEEEEERFECT delmar!!!!!!!!  and also, xcept for sinus brady cardia, all other conditions wud cause tachycardia & hypotension, not brady!!!!!!!!!!
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| smitha
Forum Elite
Topics: 53
Posts: 236
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source: NMSR
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