Podcast
Questions and Answers
Which of these is a common cause of acute pericarditis?
Which of these is a common cause of acute pericarditis?
What symptom is most typically associated with an aortic dissection?
What symptom is most typically associated with an aortic dissection?
A patient with a suspected pulmonary embolism may present with which of the following?
A patient with a suspected pulmonary embolism may present with which of the following?
What is a key diagnostic finding for pulmonary embolism that makes it unlikely in a low-risk patient?
What is a key diagnostic finding for pulmonary embolism that makes it unlikely in a low-risk patient?
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A patient with an aortic dissection involving the ascending aorta is most likely to undergo which treatment?
A patient with an aortic dissection involving the ascending aorta is most likely to undergo which treatment?
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Which radiological test is now the preferred diagnostic method for pulmonary embolism?
Which radiological test is now the preferred diagnostic method for pulmonary embolism?
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What condition is typically associated with massive left atrial dilation, causing chest discomfort in the back?
What condition is typically associated with massive left atrial dilation, causing chest discomfort in the back?
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Which symptom is defined as an abnormal awareness of breathing at rest or low exertion?
Which symptom is defined as an abnormal awareness of breathing at rest or low exertion?
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Which of the following is a typical sign of a large, central pulmonary embolism?
Which of the following is a typical sign of a large, central pulmonary embolism?
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Which of the following is a risk factor for pulmonary embolism?
Which of the following is a risk factor for pulmonary embolism?
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Study Notes
Acute Pericarditis Causes
- Idiopathic
- Infectious (viral, bacterial, fungal)
- Connective tissue diseases (e.g., lupus, rheumatoid arthritis)
- Malignancy
- Radiation therapy
- Acute myocardial infarction
- Post-myocardial infarction/cardiotomy (Dressler's syndrome)
Aortic Dissecion
- Typical patient: middle-aged or elderly with hypertension or arteriosclerosis, occasionally younger with aortic root disease (e.g., Marfan's syndrome)
- Major symptoms: chest pain, typically interscapular
- Major signs: often none, sometimes regional arterial insufficiency, cardiac tamponade, sudden death.
- Diagnosis: chest X-ray (widened mediastinum), transoesophageal echocardiogram, computed tomography (CT) scan or magnetic resonance imaging (MRI) scan.
- Comments: Type A dissections involve ascending aorta, usually treated surgically. Type B dissections involve the arch/descending aorta and usually managed medically or with an endovascular stent.
Pulmonary Embolism
- Typical patient: recent surgery, lower limb fracture, long-distance air travel, obese, sedentary, heart failure, malignancy
- Major symptoms: chest pain, dyspnoea, haemoptysis, syncope
- Major signs: peripheral emboli (pleural rub), large/central emboli (tachycardia, hypotension, cyanosis, raised jugular venous pressure)
- Diagnosis: D-dimer (negative in low-risk; pulmonary embolism very unlikely), ECG (sinus tachycardia, right bundle branch block, 'S1, Q3, T3' uncommon), chest X-ray (normal, wedge-shaped peripheral opacification, absent pulmonary vascular markings), echocardiogram (dilated right heart possible), CT pulmonary angiography (superseded V/Q scanning).
- Comments: suspect pulmonary embolism in patients with unexplained hypoxia, thrombolytic therapy for patients with shock and/or a dilated right heart on echo, patients with no risk factors should be investigated for prothrombotic states
Dyspnea
- Dyspnea is abnormal awareness of breathing, either at rest or unexpectedly low level of exertion.
- Major symptom of various cardiac disorders (Table 13.1)
- Mechanisms complex, including acute pulmonary edema with orthopnea, caused by elevated left atrial pressure.
- Reduced oxygenation in pulmonary arterioles causes hypoxaemia
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Description
This quiz covers the causes and characteristics of acute pericarditis, aortic dissection, and pulmonary embolism. Test your knowledge on the typical patients, symptoms, diagnosis, and treatment for these cardiovascular conditions. Ideal for medical students and professionals seeking to enhance their understanding of these critical topics.
