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Exam questionKROK 2Medicine ยท 2017

4 weeks after myocardial infarction a 56-year-old patient developed acute heart pain, marked dyspnea. Objectively: the patient's condition is extremely grave, there is marked cyanosis of face, swelling and throbbing of neck veins, peripheral pulse is absent, the carotid artery pulse is rhythmic, 130/min., BP is 60/20 mm Hg. Auscultation of the heart reveals extremely muffled sounds, percussion reveals heart border extension in both directions. What is the optimal treatment tactics for this patient?

Answer options

  1. Oxygen inhalation
  2. Pleural cavity drainage
  3. Puncture of the pleural cavity on the left
  4. Conservative treatment, infusion of adrenomimetics
  5. Pericardiocentesis and immediate thoracotomy
Correct answer

Pericardiocentesis and immediate thoracotomy

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