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Heart

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Acute Care Surgery

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Abstract

Seven days after undergoing a thoracotomy and repair of a cardiac laceration, a 22-year-old patient develops tachycardia, substernal chest pain (worse on inspiration) and fatigue. He is afebrile and hemodynamically stable. On auscultation, a pericardial friction rub is discovered. Electrocardiography demonstrates ST segment elevation throughout the pericardium. Helical computed tomography scan shows no evidence of a pulmonary embolism. Chest x-ray reveals expanded bilateral lungs and a normal cardiac silhouette. Which of the following would be the most appropriate management approach?

  1. (A)

    Administration of a nonsteroidal antiinflammatory agent

  2. (B)

    Pericardiocentesis

  3. (C)

    Reexploration

  4. (D)

    Insertion of a pulmonary artery catheter

  5. (E)

    Cardiac catheterization

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Author information

Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Oregon Health and Science University, Portland, OR, USA

    Matthew S. Slater MD

Authors
  1. Matthew S. Slater MD
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Editor information

Editors and Affiliations

  1. Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA

    L. D. Britt MD, MPH (Brickhouse Professor of Surgery and Chairman) (Brickhouse Professor of Surgery and Chairman)

  2. Department of Surgery, Oregon Health Sciences University, Portland, OR, USA

    Donald D. Trunkey MD (Professor) (Professor)

  3. Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA

    David V. Feliciano MD (Professor of Surgery, Chief of Surgery) (Professor of Surgery, Chief of Surgery)

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© 2007 Springer Science+Business Media, LLC

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Slater, M.S. (2007). Heart. In: Britt, L.D., Trunkey, D.D., Feliciano, D.V. (eds) Acute Care Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-69012-4_25

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  • DOI: https://doi.org/10.1007/978-0-387-69012-4_25

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-34470-6

  • Online ISBN: 978-0-387-69012-4

  • eBook Packages: MedicineMedicine (R0)

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