cardio5 gd morning..simple - showman

[ArchivalUser]

thnx showman

[ArchivalUser]

hello dear, i wil be back with full energy in few days, my exam is exactly in those days, when u are supposed to go for. 10th october.

thnx for remebering.

i been busy in few things, but i come often & remianed silent reader.

nice QS u have posted as always.

love u man. i apprecite it.

[ArchivalUser]

cool!best of luck for 10 october

[ArchivalUser]

thnx dear showman.

[ArchivalUser]

thanks for the Qs.. cheers

[ArchivalUser]

The correct answer is E. This patient suffers from an aortic dissection. Classic symptoms include abrupt chest pain of a sharp or shearing nature that often radiates to the back, abdominal pain, unequal pulses or blood pressures, and a blowing diastolic murmur. Major risk factors include hypertension, blunt chest trauma, and, as in the case of this patient with likely Marfan syndrome, connective tissue diseases. Visualization is necessary to classify the dissection and guide future treatment. Although CT/angiography is often the first test ordered, it misses approximately 1 in 10 aortic dissections. Transesophageal echocardiography is the most sensitive test for dissections and can be performed at the bedside in the ICU.

Magnetic resonance imaging (MRI) (choice A) may be used to diagnose an aortic dissection, but is not as sensitive as echocardiography. Further, ICU patients, who may be surrounded by IV poles, mechanical ventilators, and other metallic devices, are particularly poor candidates for MRI.

Depending on the location and extent of the dissection, a patient may be managed medically. This patient needs further workup, however, and is not ready for transfer to the floor (choice B).

Repeating previously negative tests (choices C and D) is unlikely to provide more information unless the patient™s condition (and presumably the dissection) worsens

[ArchivalUser]

wow.. thanks showman. did not realize TEE was so powerful.