Now, the concept once again, pretty much the continuation
of restrictive. When we talk about pericardial effusion.
The hardest on the once expense, so therefore you
expect there to be decrease cardiac output.
You expect there to be increase accumulation of
fluid within the pulmonary veins.
So therefore, there will be pulmonary edema.
I’m walking through this quickly
because we have done this so many different times.
Dyspnea, fatigue, hepatomegaly. Why? Why?
The heart is not filling. Back-up. From where?
Not the left side. Right? You back-up from the right side.
You back-up from the right side. Into where?
Inferior vena cava.
Where you going? Liver. What’s gonna happen? Hepatomegaly.
Right? Ascites. How was that occurring?
Oh maybe there was half a liver damage taking place?
And so there many ways in which you would be developing
increase accumulation of fluid.
You have already heart that has decrease cardiac output.
And have the liver is not functioning, well.
Well,maybe end up having poor hypertension.
Decrease oncotic pressure.
Are you with me? So lot of physiology here.
Then we have to bring in.
Remember all of medicine, all of medicine is normal.
Pathology is well. Physiology gone array.
And then, how do you manage your patient?
Alright? So you get that down. My goodness.
You’ve got 90-95 % of medicine down. And then, all you
have to do is filling the details. That entrust me.
That is a eternal journey. Okay? Please don’t
feel overwhelmed. You’re here because you need help.
You’re here so that you can get support.
That’s all we’re trying to do.
Let’s continue. You got this. Feel good about
what you’re doing.
Peripheral edema, sure. Why?
Constrictive pericarditis, right side.
Physical examination, reveal a characteristic pericardial
knock. Kussmaul’s sign, is going to be your positive JVD.
More so with constrictive pericarditis.
Not usually seen of cardiac tamponade.
Because remember cardiac tamponade, whoom. Fluid
accumulating pericardial cavity, very, very rapid.
And so therefore, you’re looking at issues
in which hypertension takes place very quickly.
Hemodynamically unstable that patient. Cardiac Tamponade.
Give yourself an example such as ventricular wall rupture.