Week 5 discussion “


A 35-year-old man complains of dyspnea and substernal chest pain,

aggravated by inspiration and relieved by sitting up. The patient has had a
history of tuberculosis. Chest x-ray shows an enlarged cardiac silhouette.
Lung fields are clear. The patient develops hypotension and jugular venous
distension ; there i s an inward movement of the j ugular pulse s ynchronous
with the pulse of the carotid artery . The ECG shows electrical al tern ans .
1. What is the next step in evaluating this patient?
2 What is the most likely important additional finding?
3 What is your diagnosis at this time? Explain?
4 How to treat this condition?

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