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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Impression From The Chest Scan?

Hi, I have a client who I cannot hear hear sounds on. He has no discomfort in his neck chest or arms. Afebrile T 37.4. He describes a fluttering feeling in his chest. He has a pacemaker that he had checked 2 months agao and was told is functioning well. He has strong peripheral pulses regular radial 56 bpm. He is hemodialyzing presently. We returned his blood and I auscultated again with no change in hearing heart sounds. Hios BP is stable 151/56. My impression? pericardial tamponade/pericarditis??
Thu, 19 Feb 2015
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Cardiologist,  's  Response
Hello! Thank you for your question! Regarding your concern I don't believe it is a pericardial tamponade/neither a pericarditis. Pericardial tamponade would be the end of a dyspneic and hypotensive situation; with distended jugular veins; tachycardia, lowered blood pressure (the patient doesn't seem to experience any of them). Also pericarditis will show a clinical picture dominated by chest pain (modulated by respiration and posture), etc.
I recommend the patient to consult a cardiologist for exploring that fluttering feeling, as we don't' know the reason of pacemaker implantation (was is a brady-tachy syndrome, atrio-ventricular block or something else), as well as the associated cardiac problem that could predispose to arrhythmia.
Hope to have been helpful.
Greetings from Dr. Iliri
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What Is The Impression From The Chest Scan?

Hello! Thank you for your question! Regarding your concern I don t believe it is a pericardial tamponade/neither a pericarditis. Pericardial tamponade would be the end of a dyspneic and hypotensive situation; with distended jugular veins; tachycardia, lowered blood pressure (the patient doesn t seem to experience any of them). Also pericarditis will show a clinical picture dominated by chest pain (modulated by respiration and posture), etc. I recommend the patient to consult a cardiologist for exploring that fluttering feeling, as we don t know the reason of pacemaker implantation (was is a brady-tachy syndrome, atrio-ventricular block or something else), as well as the associated cardiac problem that could predispose to arrhythmia. Hope to have been helpful. Greetings from Dr. Iliri