Manoj Wickramasinghe

Follow @Manoj_Wickram

6 Feb, 5 tweets, 4 min read

#askpocus case. Indigestion type chest pain with some pleuritic nature. Troponin ++. Lateral TWI. Initially suspected ACS but CTPA showed PE so treated accordingly. @askpocus @daniel_opazo @NephroP @Wilkinsonjonny @iceman_ex @cianmcdermott @nick_wroe @IMPOCUSFocus @The_echo_lady

So why was troponin so raised? Bedside echo! Not the greatest of views but enough to comment. PLAX...

PSAX...

Apical 4cH

So with those images - what do we think is going on? Will reveal answer (or at least what I think!) in due course #POCUS #echofirst #FUSIC

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More from @Manoj_Wickram

Manoj Wickramasinghe

@Manoj_Wickram

4 Feb

Train the eye - part 3. Cardiac tamponade! #askpocus #echofirst #pocus @NephroP @Wilkinsonjonny @icmteaching @IMPOCUSFocus @dr_benoy_n_shah @cianmcdermott @EmergencyEcho @KalagaraHari @RJonesSonoEM @DRsonosRD @SonoSerious @iceman_ex @daniel_opazo

https://twitter.com/eabramsmd/status/935510082875478016?s=21

There are several sonographic signs of cardiac tamponade...

https://twitter.com/emedicalacademy/status/1229784920198991874?s=21

Right ventricular end diastolic collapse – relatively low sensitivity, relatively high specificity

https://twitter.com/drshukla14/status/1205380670677225472?s=21

Manoj Wickramasinghe

@Manoj_Wickram

2 Feb

Another train the eye thread. This time - Takutsubos cardiomyopathy 🐙! #POCUS #askpocus #echofirst @iceman_ex @cianmcdermott @icmteaching @load_dependent @daniel_opazo @KalagaraHari @DRsonosRD @tsquaredmd @coreultrasound @IMPOCUSFocus @nick_wroe @askpocus @The_echo_lady

Also known as stress induced cardiomyopathy/takutsubos syndrome/broken heart syndrome

https://twitter.com/manoj_wickram/status/1344939071798390784

Classically you get apical ballooning and akinesis with basal preservation.

https://twitter.com/ozlembilen2/status/1281633360998170625

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