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Abdominal Aortic Anerysm Differenial in BP b/w the Px’s Arm – secondary to Subclavian Atherosclerotic dz o Aortic Dissection = Greater RIGHT ARM BP + SMOKING HX SYSTOLIC BRUIT o RAS = Greater LEFT ARM BP SYSTOLIC-DIASTOLIC BRUIT QID: 3768 Adenosine inhibits L-type Ca channels, decreasing conduction velocity in the AV node CARDIOLOGY Qid 3635 Recent Immigrant from China Endemic Areas (Africa, India & China) CC: Fatigue and Dyspnea on Exertion = decrease Cardiac Output Abdominal distention for the Past 2 months = Hepatosplenomegaly SHx: Farmer his entire life VS: wnl PE: (Signs of Venous Overload) Pedal Edema Increase abdominal girth with free fluid = Ascities Elevated JVP without Inspiratory decline = KUSSMAUL SIGN Chest Ausculation = decrease heart sounds & Accentuated sound directly after the S2 in Early Diastole = “KNOCK” OF S3 GALLOP CXR = ring of calcification around the heart Pericardial Fibrosis JVP Tracing: Prominent X & Y DESCENTS Q: Most likely cause of symptoms? TB *** Dx: Constrictive Pericarditis In US, MCC of Constrictive Pericarditis include: Idiopathic or Viral Pericarditis (>40%) Radiation Therapy (~30%) Cardiac Surgery (~10%) Connective Tissue Disorders Tachypnea & Dyspnea occurs when CO becomes compromised Qid: 4682 Renal Artery Stenosis vs.