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Focused assessment with sonography in trauma (commonly abbreviated as FAST) is a rapid bedside ultrasound examination performed by surgeons, emergency physicians, and paramedics as a screening test for blood around the heart (pericardial effusion) or abdominal organs (hemoperitoneum) after trauma.
Purulent Pericarditis; Echocardiogram showing pericardial effusion with signs of cardiac tamponade: Specialty: Cardiology: Symptoms: substernal chest pain (exacerbated supine and with breathing deeply), dyspnea, fever, rigors/chills, and cardiorespiratory signs (i.e., tachycardia, friction rub, pulsus paradoxus, pericardial effusion, cardiac tamponade, pleural effusion)
A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous connective membrane and an inner two-layered serous membrane .
Depending on severity, dosing is between 300 and 800 mg every 6–8 hours for days or weeks as needed. An alternative protocol is aspirin 800 mg every 6–8 hours. [14] Dose tapering of NSAIDs may be needed. In pericarditis following acute myocardial infarction, NSAIDs other than aspirin should be avoided since they can impair scar formation.
Whether an effusion causes tamponade depends on the amount of fluid and how long it took to accumulate. When fluid collects slowly, the pericardium can stretch. Thus, a chronic effusion can be as large as 1 liter. [20] Acute effusions can cause tamponade when small because the tissue does not have time to stretch. [21]
Pulsus paradoxus is a sign that is indicative of several conditions, most commonly pericardial effusion. [ 1 ] The paradox in pulsus paradoxus is that, on physical examination , one can detect beats on cardiac auscultation during inspiration that cannot be palpated at the radial pulse . [ 1 ]
The differential diagnoses of Kussmaul's sign includes constrictive pericarditis, restrictive cardiomyopathy, pericardial effusion, and severe right-sided heart failure. [ citation needed ] With cardiac tamponade , jugular veins are distended and typically show a prominent x descent and an absent y descent as opposed to patients with ...
The typical signs of post-pericardiotomy syndrome include fever, pleuritis (with possible pleural effusion), pericarditis (with possible pericardial effusion), occasional but rare pulmonary infiltrates, and fatigue. [1] [2] Cough, pleuritic or retrosternal chest pain, joint pain and decreased oxygen saturation can also be seen in some cases. [1]
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