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• Infection -viral, bacterial• Secondary to recent cardiac surgery• Post MI• IV Drug abuse• Kidney failure• Metatastic disease
Restricts the heart – reduces operative chamber compliance
Thickened pericardium isolates heart from normal respiratory swing, however respiratory fluctuations in pulmonary venous pressure still occurs
Tamponade
Bacterial – antibiotics Fungal – antifungal agents Hospitalisation Constictive
Pericardetomy may be required
ST elevation in any lead May be in all leads May not be anatomically grouped J-point notching can be
presentpresent Fish hook
• Look for notch at J-pointLook for notch at J-point
– ST segment and J-point create a “fish ST segment and J-point create a “fish hook” appearancehook” appearance
Stage Ieverything is UP (i.e., ST elevation in almost all leads - see below)
Stage IITransition ( i.e., "pseudonormalization").
Stage IIIEverything is DOWN (inverted T waves).
Stage IV Normalization
Viral – coxsackievirus B Bacteria – Staphyloccus aureus, borrelia
burgdorferi Diptheria Parasites – trypanosoma cruzi Fungi Chemicals Medications Systemic diseases
REST Steroids – severe cases May need to manage electrolyte
imbalances or complications of heart failure
NB 10% of patients proceed to develop dilated cardiomyopathy