Right heart failure (cor pulmonale) Quiz: Ace Your Exams
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A 66-year-old man presents to the emergency department for evaluation of worsening shortness of breath for the past three weeks. The patient's partner called EMS when the patient collapsed after standing up from the couch. The patient has a past medical history of heart failure, hypertension, diabetes, and a 20 pack-year smoking history. Medications include aspirin, amlodipine, carvedilol, metformin, and furosemide. Temperature is 37°C (98.6°F), pulse is 130/min, respirations are 20/min, blood pressure is 76/54 mmHg, and oxygen saturation is 92% on room air. The patient is ill-appearing, diaphoretic, and tachypneic at rest. Cardiopulmonary examination reveals distended neck veins, distant heart sounds, and bibasilar rales. ECG is notable for low-voltage QRS complexes in all leads. A bedside ultrasound is performed, which is displayed below. One of the findings is a large pericardial effusion. Which of the following is the best initial step in management while waiting for emergency staff to collect procedure supplies?
Reproduced from: Wikipedia
Reproduced from: Wikipedia
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