Question

Patient 5 days after MI with acute onset chest pain, profound shock, and pulselessness:

a) Cardiogenic shock
b) Ventricular fibrillation
c) Cardiac tamponade
d) Septic shock

Answer 1

A patient presenting with acute chest pain, shock, and pulselessness following an MI is likely experiencing cardiac tamponade, a critical condition where fluid in the pericardial sac compresses the heart.

Step-by-step explanation:

The patient in question is exhibiting symptoms that are consistent with cardiac tamponade, which is an emergency condition where fluid accumulates in the pericardium (the sac around the heart), leading to decreased cardiac output. This accumulation of fluid puts pressure on the heart, preventing it from filling properly, which can result in shock and sudden cardiac arrest. The key symptoms to consider for this diagnosis are acute chest pain, profound shock, and pulselessness. Other conditions like cardiogenic shock, ventricular fibrillation, and septic shock could also present similarly, but the recent history of myocardial infarction (MI) and the acute onset of symptoms point to tamponade. In such a condition, the removal of fluid from the pericardial cavity is imperative to restore cardiac function and can be life-saving.