164) A 64 year old man is seen in the Emergency room for sharp sub sternal chest pain that started few hours ago. The pain increases on coughing and deep breathing. His history is significant for Acute Myocardial Infarction about 6 weeks ago. At that time, he was treated with percutaneous coronary intervention and stent placement. On physical examination, temperature is 100F, Heart rate 88/min, and Blood pressure 110/70 mm Hg. Pulsus paradoxus is 8mm Hg and lungs are clear to auscultation. A chest X-ray reveals enlargement of cardiac shadow. The most appropriate treatment for this patient’s presentation:
A) Pericardiocentesis
B) Oral Ibuprofen
C) Oral Prednisone
D) Metoprolol
E) Cardiac catheterization to evaluate stent re-occlusion
a
h/o MI 6 weeks ago = myocardial rupture/vetricular aneurysum? which cause tamponade?
b
B) Oral Ibuprofen