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Pericarditis refers to inflammation of the pericardium The pericardium is a sac within which the heart sits. Acute inflammation of this sac is known as acute pericarditis. About 5% of patients who present to A+E with chest pain which is not deemed to be a heart attack or angina are ultimately diagnosed with pericarditis.
An unfilled heart is not able to pump out blood well and the bloodpressure falls. There are other tests also for tuberculous pericarditis, but they not as sure as growing the bacterium in culture. Pericardial effusion is usually confirmed by an echocardiogram (ultrasound study of the heart).
So I immediately left the room to get an ultrasound machine. The cardiac monitor showed sinus rhythm but the automatic bloodpressure cuff was not reading. We arrived in the resuscitation bay and recorded a heart rate of 115 bpm and bloodpressure of 50/30 mm Hg. Why would she have such varying bloodpressure?
A bedside cardiac ultrasound was performed with a parasternal long axis view demonstrated below: There is a large pericardial effusion with collapse of the right ventricle during systole. The second most common cause of medical cardiac tamponade is acute idiopathic pericarditis. This patient is only pseudo-stable. Her pulse is 125.
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