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Related Concept Videos

Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

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The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
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Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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Measurement of Blood Pressure01:17

Measurement of Blood Pressure

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Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
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Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

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Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
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Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

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The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
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Pericarditis I: Introduction01:22

Pericarditis I: Introduction

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Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
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Updated: Mar 23, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Paradoxical Hemodynamic Instability After Pericardial Window.

Andrew J Han1, Teresa Slomka2, Anurag Mehrotra3

  • 1Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.

Echocardiography (Mount Kisco, N.Y.)
|April 6, 2016
PubMed
Summary
This summary is machine-generated.

Paradoxical hemodynamic instability (PHI) is a rare complication after pericardial effusion drainage. This case highlights the condition

Keywords:
cardiac tamponadepericardial effusionpericardial effusion therapypericardial windowpericardiocentesissubxiphoid pericardiectomy

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Area of Science:

  • Cardiology
  • Critical Care Medicine

Background:

  • Pericardial effusion (PEf) drainage can rarely lead to paradoxical hemodynamic instability (PHI), also known as postoperative low cardiac output syndrome (LCOS).
  • The exact mechanisms underlying PHI post-PEf drainage remain poorly understood.
  • PHI is a critical complication, often fatal, developing hours after effusion drainage.

Observation:

  • An 84-year-old patient presented with acute shortness of breath and echocardiography-confirmed cardiac tamponade.
  • Following emergent subxiphoid pericardiectomy, the patient developed severe hemodynamic instability and shock.
  • Post-procedure echocardiography showed left ventricular hypercontractility and new right ventricular dilatation with akinesis.

Findings:

  • Despite maximal pressor support, the patient's condition deteriorated, leading to multiorgan failure.
  • The case illustrates a fatal outcome in PHI despite aggressive medical management.
  • Echocardiographic findings suggested a complex interplay of ventricular dysfunction post-pericardiectomy.

Implications:

  • This case underscores the need for further research into the pathophysiology of PHI.
  • Early recognition and understanding of PHI mechanisms are crucial for potential therapeutic strategies.
  • Improved diagnostic and management protocols may be necessary for patients undergoing pericardial effusion drainage.