Case 13

Question 1

What are the classic signs of a cardiac tamponade?

Answer 1

Hypotension

muffled heart sounds

ncreased jugular venous distension (JVD)

aka. Beck’s triad!

Cardiac tamponade is a pathological compression of the heart caused by excess fluid in the pericardial sac. Cardiac output is reduced as myocardium cannot contract efficiently leading to hypotension. The accumulation of fluid in the pericardial sac has an insulating effect leading to the heart sounds becoming muffled. JVD is increased as a result of increased venous pressure due to the backflow of blood into veins which is due to the reduced cardiac output.

Question 2

This is Torades de Pointes.

What predisposes to this arrythymia?

Answer 2

hypomagnesemia, hypokalemia, hypocalcemia, long QT interval.

TdP is polymorphic ventricular tachycardia with increasing and decreasing amplitude.