Patient <24 hours after CABG who develops hypotension, decreased urine output, decreased cardiac output and a widened mediastinum, concerning for mediastinal bleed
Key idea: Post-op patients with acute hemodynamic instability almost always will require surgical exploration/correction (especially in NBME questions)
lindasmith462what does that increased pulmonary artery diastolic pressure mean in this question? (I'm just wondering if it has anything to do w/ Type A aortic dissection vs the more common mediastinal hemorrhage+
quaranqueenjust a guess - maybe pulmonary artery compression due to bleeding in the mediastinum, so increased diastolic pressure+2
charcot_bouchardI think its more like cardiac tamponade scenario. ext compression. +1
submitted by โthajoker(21)
s/p CABG, decreased CO and hypotension, CXR shows widened mediastinum --> mediastinal hemorrhage