Acute dyspnea & Chest pain

Chief Complaint A 34 y/o female presents to the hospital with acute dyspnoea and chest pain. History No past medical history of any disease. Vitals BP 125/80 mmhg, Pulse 118 bpm. Heart rate 57 bpm, Temp: 97.5 degree c. Investigations Hb 9.8 g/dl, leukocyte count 5,400/μm, platelet count 250 × 103 /μm, rest of the blood investigations are normal. ABC: pH 7.3, PaO2 60 mmHg and PaCO2 36 mm Hg. Chest X-ray shows mild cardiomegaly. ECG shows sinusal tachycardia. Echocardiography shows pericardial effusion. CT scan was done then, which shows massive thickening of the left pericardium with pericardial effusion. Diagnosis What does this show? Share your valuable opinion.

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Massive thickening of pericardium with pericardial effusion and pt is hypoxic with tachycardia most likely tubercular But 8n present era of covid we need to r/o it also

Thanx dr Kute Ankush
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A case of Pericardial effusion with cardiac tamponade. As it is sudden in onset and patient is 34 years female most likely possibilities are 1.Pericardial effusion and tamponade in a pre - existing Pericarditis ( Rheumatic? ) 2.Viral infection, Coxsackie virus 3.Following acute M.I Treatment remains Pericardiocentesis as an emergency measure

Thickened pericardium with effusion means chronic pericarditis? Tubercular ,or Pyogenic . Sudden SOB with chest pain with tachycardia is likely to be due to tamponade. Suggest diagnostic and therapeutic Pericardial tapping and drainage .Pericardial biopsy. Pericardial aspirate for AFB and CBNATT and C&S.

HEART ENLARGEMENT you can choose from a wide range of medicines that act as cardiac tonics first thing is to maintain BP as mostly cardiomegally is the outcome of hypertension and dysponea is the commonest complaint. start with arjunarisht punarnava arishth, rightly said punarnava mandur, sarpgandha jatamansi ajwain khurasani ashwagandha akik pishti yashad pishti praval pishti gokshur there is one unani preparation khamira ab resham it contains cocons of resham fibers behman surakh behman safed honey and some other herbs but its result as cardio toinc is good, cap. lipan abana can be considered

? PERICARDIAL EFFUSION.. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH EXPERTS OPINION TO CONCLUDE DIAGNOSIS AND TREATMENT..

Evaluate as Infective vs ischemic cause of pericardial effusion.

Finding out the specific cause of pericardial effusion is the first priority. If reveals treat accordingly. Secondly, correct anaemia,record & monitor vital signs routinely.Give conservative treatment. An antidepressant should be added. ---Thanks.

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