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  • q
      • Anonymous (no login)
      Posted Oct 20, 2007 5:35 AM


      You are called by the intensive care unit nurse to evaluate a patient who is complaining of increasing shortness of breath. The patient was admitted 4 days ago for an acute anterior wall MI and underwent percutaneous intervention of her right coronary artery. Upon your arrival the patient is in severe respiratory distress. Her heart reveals a very loud early systolic murmur heard in the apex as well as at the base, and a sternal heave is felt. She has bilateral pleural rales. She has elevated jugular venous pressure. The most likely diagnosis is:
      a) Acute stent rethrombosis.
      b) Ventricular septal rupture.
      c) Pericardial tamponade.
      d) Posteromedial papillary muscle rupture.
      e) Pulmonary embolism with acute tricuspid regurgitation.

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