Dr. Usman's Cardiology Notes

Its Apical muscular VSD with left to right shunt and mild pericardial effusion. Its a dangerous post MI complication, mortality is 25% at day-3 and 75% at 3 weeks of MI, if treated medically. Best management is s urgical closure of VSD

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...