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Bedside cardiac ultrasound showed moderately decreased LV function. Because she has cardiomyopathy and ventricular dysrhythmias, the pacer included an Implanted Cardioverter-Defibrillator (ICD) Echo 6 days later after CRT: Normal estimated left ventricular ejection fraction. She was intubated. No wall motion abnormality.
Blunt cardiac injury my result in : 1) Acute myocardial rupture with tamponade 2) Valve rupture (tricuspid, aortic, mitral) 3) Coronary thrombosis or dissection (and thus Acute MI) from direct coronary blunt injury 4) Dysrhythmias of all kinds. In the ED, ultrasound showed hemopericardium with tamponade.
Echocardiography – We can use ultrasound to visualize the heart and look at how well it pumps. With this test, an echocardiogram is done at rest to study the pumping ability of the heart. As the heart becomes more muscular, it becomes stiffer and therefore does not fill with as much blood and therefore pumps less blood out.
Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.
Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. Good History and Physical exam, including a.
A bedside POC cardiac ultrasound was done: Findings: Decreased left ventricular systolic function. Later, he underwent a formal echocardiogram: Very severe left ventricular enlargement (LVED diameter 7.4 A diagnostic NT-proBNP cutoff of 900 pg/mL has been suggested in adults 50-75 years of age in absence of renal failure."
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