How do you manage Pericardial Effusion ? - jeanbaptiste

[ArchivalUser]

Well~ my friend who finished step3 yesterday told me the case of pericardial effusion.

pt. was male in his 50s
c/o chest pain
HR: 110
BP: 170/110

ekg had pr depression and st elevation.
and echo showed thickened pericardium with small pericardial effusion.

how do you manage or treat this kind of patient ?
Do they have a similar case in UW ?

[ArchivalUser]

If Acute onset + elevated ESR + Fever, consider viral cause. Tx. NSAIDS
If COMORBID conditions ( uremia, TB, malignancy, lupus or other autoimmune disease), treat accordingly.
If cardiac tamponade + Unstable pt = pericardiocentesis (or dyalisis if cause is CRF)

There was a case in UW in which the correct answer was NSAIDS.

[ArchivalUser]

to me this sounds more like pericarditis.....
what do you think guys???

[ArchivalUser]

yes cricoid is pericarditis remember if it was 3-4 weeks after MI then think dressler
Pericarditis is just medical management, Chem14, ABG, control BP, oxygen, IBV fluids, monitor patient, etc...

[ArchivalUser]

yes this should be easy to handle...

[ArchivalUser]

but for me, I am slightly worried about 'thickened pericardium'

isn't that finding of constrictive pericarditis ?

do we have to do biopsy or fluid analysis of the pericardium ?

[ArchivalUser]

this seems more like pericarditis than effusion. more so because of the ekg changes and chest pain which are unsuaul in effusion.
rx ...........nsaids, thickened pericardium with some effusion.......so draw some fluid for analysis and proceed with biopsy if req.

[ArchivalUser]

Thanks yettobe !

do they have the order of 'pericardial biopsy' or 'fluid analysis' in Primum CCS CD ?

[ArchivalUser]

no pericardial biopsy needed jean...but yes there's an option