Pericardial Disease

Reference: Davidson 23rd , Page : 542
Explanation : Specific indicator of acute pericarditis in ECG is PR interval depression .

The pivotal investigation is echocardiography, which can confirm the diagnosis and also helps to identify the optimum site for aspiration of the fluid.

Constrictive pericarditis is a possibility when ascites is out of proportion to peripheral edema.

The diagnosis can often be made on the basis of clinical features and the ECG; the latter shows ST elevation with upward concavity over the affected area, which may be widespread. PR interval depression is a very specific indicator of acute pericarditis.

Reference: Davidson 23rd; P-544
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd , Page : 543
Explanation : chronic constrictive pericarditis is sometimes overlooked but should be suspected in any patient with unexplained right heart failure and a small heart.
Differential diagnosis of small heart : Chronic constrictive pericarditis,Addison’s disease, Starvation.

Pulsus paradoxus, a decrease in systolic blood pressure of more than 10 mmHg during inspiration, is a classic finding in cardiac tamponade. Davidson explains that in tamponade, fluid accumulation in the pericardium compresses the heart, reducing ventricular filling during inspiration and leading to a drop in blood pressure. Harrison adds that pulsus paradoxus can be detected by palpating the pulse or measuring blood pressure during the respiratory cycle.

Reference: Davidson 23rd; P-543
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-542