You are asked to review a 60-year-old man on the Cardiothoracic ward 24 hours after coronary bypass grafting. He has become breathless and feels dizzy and faint. BP 90/60 mmHg and PR 120 beats/minute, [His IVP is 8 cm above the sternal angle, and the apex beat is impalpable. On auscultation, heart sounds are softly audible and lung fields are clear. An ECG shows an alternas pattern. What is the most likely diagnosis?
سؤال مجاني 8 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. Cardiac tamponade
24 h after CABG (a cause of haemopericardium) he has hypotension, tachycardia, raised JVP, soft heart sounds, an impalpable apex and electrical alternans on ECG — all pointing to cardiac tamponade. PE and RV infarction can raise JVP but do not cause soft heart sounds or alternans, and constrictive pericarditis is a chronic process.
ليش كل خيار صح أو غلط
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A
ليش صح
Tamponade can show sinus tachycardia, low-voltage QRS and electrical alternans, matching the ECG, together with hypotension and soft heart sounds after bypass surgery.
✓ CARDIOLOGY - PERICARDIAL DISEASES.pdf · p. 8 -
B
ليش غلط
PE causes obstructive shock through high afterload: pulmonary artery occlusion raises pressure behind the clot and lowers RV output. Soft heart sounds and electrical alternans are not part of this description.
✓ 14• Shock [Notes].pdf · p. 2 -
C
ليش غلط
RV infarction is RCA territory (the RCA supplies the right ventricle), shown by ST changes in II, III, aVF and right-sided leads, not by electrical alternans.
✓ (Y4)-(M B) Ischemic Heart and Acute coronary syndrome.pdf · p. 9 -
D
ليش غلط
Septic shock is distributive: infection, cytokines and vasodilation, presenting with fever and leukocytosis. It does not account for soft heart sounds and electrical alternans after surgery.
✓ 14• Shock [Notes].pdf · p. 3 -
E
ليش غلط
Constrictive pericarditis is thickening and calcification of the pericardium that impairs filling, often following TB or radiation. It is a chronic process, not a 24-hour postoperative picture.
✓ CARDIOLOGY - PERICARDIAL DISEASES.pdf · p. 4
- المصدر
- CARDIOLOGY - PERICARDIAL DISEASES.pdf · p. 6
CARDIOLOGY - PERICARDIAL DISEASES.pdf · p. 8 - المحاضرة
- Pericardial Disease · Cardiology · Module B
- ظهر في
- Cardio bank