Pericardial Disease I

Cardiovascular System


{"ops":[{"insert":"A 54-year-old woman with end-stage renal disease comes to the physician with fatigue and shortness of breath on exertion for three days. She missed her routine hemodialysis sessions; the last was two weeks ago. Her pulse is 98\/min, blood pressure is 140\/70 mmHg, and respirations are 16\/min. The lungs are clear to auscultation. Heart sounds are muffled. An ECG shows low voltage QRS complexes in all leads. An x-ray of the chest reveals cardiomegaly. Which of the following is the most appropriate next step in management?"},{"insert":"\n"}]}

Background

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(A)

Hemodialysis
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(B)

Pericardiocentesis
{"ops":[{"insert":"\n"}]}

(C)

Pericardial window
{"ops":[{"insert":"\n"}]}

(D)

Pericardiectomy
{"ops":[{"insert":"\n"}]}

(E)

Oral corticosteroids
{"ops":[{"insert":"\n"}]}

References

{"ops":[{"insert":"REHMAN KA, BETANCOR J, XU B, KUMAR A, RIVAS CG, SATO K, WONG LP, ASHER CR, KLEIN AL. Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end-stage renal disease: Insights and pathophysiology. Clin Cardiol [online] 2017 Oct, 40(10):839-846 [viewed 16 May 2019] Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28873222"},{"insert":"\n","attributes":{"list":"ordered"}},{"insert":"SADJADI SA, MASHAHDIAN A. Uremic pericarditis: a report of 30 cases and review of the literature. Am J Case Rep [online] 2015 Mar 22:169-73 [viewed 16 May 2019] Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25796283"},{"insert":"\n","attributes":{"list":"ordered"}}]}

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