Dr. Usman's Cardiology Notes

A  45 year old male smoker presented with chest pain radiating to neck and left shoulder for last 7 days. Examination was significant for resting tachycardia and pericardial friction rub with clear lung fields. ECG showed sinus tachycardia, diffuse ST elevation in all leads except aVR, V1. Troponins were modestly elevated. CBC, ESR, ANA, TFTs, all were normal. a)       What is the diagnosis (complete diagnosis) b)       What is the cause of troponin elevation c)       Would you consider colchicine? If yes then give reason d)       What are echo Doppler findings of constrictive pericarditis e)       What is Becks traid Answers: a.       Acute MyoPericarditis b.       Myocardial Involvement c.        Yes, it reduces risk of recurrence, COPE Trial d.    ...

A 44 year old female presented with low grade fever, dysphagia, hiccups and weight loss for 3 months. On examination BP was 100/60, regular pulse 100bpm, muffled heart sounds with pericardial friction rub. ECG was of low voltage and chest X-ray showed enlarged cardiac shadow. ESR was 70mm/hour. PPD 9mm. Echocardiogram revealed large pericardial effusion a)       What is diagnosis? b)       How would you treat pericardial effusion if it is recurrent? c)       What are the treatment options available? d)       Are steroids indicated?   Answers: a.       Tuberculous pericardial Effusion b.       Pericardiocentesis, pericardial window pericardiotomy c.        Triple therapy INH/Rifampicin/Ethambutol for 9 months d.       Constrictive tuberculous pericarditis steroids are given, but i...