Cardiology 3A

CASE 1:
Link to the patient details: 

 https://muskaangoyal.blogspot.com/2021/05/a-78year-old-male-with-shortness-of.html

.What is the difference btw heart failure with preserved ejection fraction and with reduced ejection fraction?




Ans:Preserved ejection fraction (HFpEF) – also referred to as diastolic heart failure. The heart muscle contracts normally but the ventricles do not relax as they should during ventricular filling (or when the ventricles relax). 


Reduced ejection fraction (HFrEF) – also referred to as systolic heart failure



        

HFpEF is preceded by chronic comorbidities, such as hypertension, type 2 diabetes mellitus (T2DM), obesity, and renal insufficiency, whereas HFrEF is often preceded by the acute or chronic loss of cardiomyocytes due to ischemia, a genetic mutation, myocarditis, or valvular disease  





2.Why haven't we done pericardiocenetis in this pateint?


        


Ans: Pericardiocentesis is not done here  Because the effusion was self healing ,It reduced from 2.4cm to 1.9 cm.



        


3.What are the risk factors for development of heart failure in the patient?



Ans: risk factors for development of heart faliure in this patent


Alcohol abuse increases the risk of atrial fibrillation, heart attack and congestive heart failure 


high blood pressure


Smoking


Diabetes


AV block can be associated with severe bradycardia and hemodynamic instability. It has a greater risk of progressing to third-degree (complete) heart block or asystole.


wosening of pericardial effusion leaing to cardiac tamponade.



4.What could be the cause for hypotension in this



Ans : visceral pericardium may have  thickened which is restricting the heart to expand causing hypotension 


(May be secondary to TB)

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