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#perikardiyal #tamponad #smartus #konuanlatım Tus ve Ydus için deneme sınavı hizmeti 1500'den fazla çıkmış soru benzerleri ve konu anlatımları şimdi ücretsiz olarak web adresimizde...","preview":{"posterSrc":"//avatars.mds.yandex.net/get-vthumb/4511508/7bee7dc48f84d4821a7c173f273943e2/564x318_1","videoSrc":"https://video-preview.s3.yandex.net/IigjGQIAAAA.mp4","videoType":"video/mp4"},"target":"_self","position":"13","reqid":"1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL","summary":{"isFull":true,"fullTextUrl":"/video/result?ask_summarization=1&numdoc=1&noreask=1&nomisspell=1&parent-reqid=1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL&text=videoid:8351819115135019152","teaser":[{"list":{"type":"unordered","items":["Bu video, \"Hastalık Monografları\" serisinin bir parçası olarak sunulan, bir konuşmacı tarafından hazırlanan sağlık eğitimi formatında bir ders anlatımıdır.","Video, kardiyak tamponat hastalığının tanımı, patofizyolojisi, etyolojisi ve klinik bulguları hakkında kapsamlı bilgiler sunmaktadır. İçerikte tamponatın perikardiyal boşlukta toplanan sıvının kalbin doluşunu engellemesi sonucu geliştiği, akut ve kronik etyolojileri, pulsuz paradoks gibi klinik bulguları ve tanı yöntemleri (ekografya, doppler) detaylı olarak açıklanmaktadır.","Ayrıca, benzer durumlar olan sağ ventriküler miyokard enfarktüsü, konstrüktif perikardit ve restrüktif kardiyomiyopati ile nasıl ayırt edileceği, tedavi yöntemleri (perikardiyosentez) ve gerçek hayattan vaka örnekleri de sunulmaktadır. Video, sınavlarda tamponatı tanımlamak için dikkat edilmesi gereken anahtar noktaları vurgulayarak, her hekimin kliniğinde şüphelenmesi gerektiği mesajıyla sonlanmaktadır."]},"endTime":1233,"title":"Kardiyak Tamponat Eğitim Videosu","beginTime":0}],"fullResult":[{"index":0,"title":"Kardiyak Tamponat Tanımı ve Önemi","list":{"type":"unordered","items":["Kardiyak tamponat, perikardiyal boşlukta toplanan sıvının ventrikülün doluşunu engelleyecek derecede olması sonucunda gelişen, acil ve doğru tanı konulmaması durumunda kısa sürede fatalite ile sonuçlanabilecek bir durumdur.","Normalde perikard boşluğunda 50 cc'den fazla sıvı bulunmaz, ancak akut durumlarda 200 cc'ye ulaştığında kalbin relaksasyonunu ve doluşunu bozarak dolum volümü, atım volümü ve kardiyak output'u azaltır.","Kronik durumlarda perikardın gerilebilme özelliği sayesinde 2000 cc'ye kadar sıvıyı tampon oluşturmadan taşıyabilir."]},"beginTime":16,"endTime":95,"href":"/video/preview/8351819115135019152?parent-reqid=1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL&text=Health+Ed+Hub&t=16&ask_summarization=1"},{"index":1,"title":"Patofizyoloji ve Görüntüleme","list":{"type":"unordered","items":["Tamponatta temel problem ventrikülün doluşunun bozulmasıdır, bu da kardiyak output'u düşürerek hipotansiyon ve kardiyojenik şok gelişmesine neden olur.","Perikard boşluğunda artan sıvı miktarı, kalbe baskı uygular ve diastolde kalbin genişlemesini bozar, bu da end-diastolik volümü azaltır.","End-diastolik volüm azaldığında sistolide dışarı atılan kan miktarı da azalır, bu da kardiyak output'u düşürerek hipotansiyon meydana getirir."]},"beginTime":95,"endTime":158,"href":"/video/preview/8351819115135019152?parent-reqid=1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL&text=Health+Ed+Hub&t=95&ask_summarization=1"},{"index":2,"title":"Etiyoloji","list":{"type":"unordered","items":["Perikardiyal efüzyon yapabilen durumlar tamponat oluşturabilir, bunlar akut ve kronik zeminde yapanlara ayrılabilir.","Akut yapanlar: travmalar, ventrikül rüktürü, kalp cerrahisinin komplikasyonu ve aort diseksiyonudur.","Kronik zeminde yapanlar: tüberküloz, viral enfeksiyonlar, metastatik kanser ve böbrek yetmezliğidir."]},"beginTime":158,"endTime":217,"href":"/video/preview/8351819115135019152?parent-reqid=1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL&text=Health+Ed+Hub&t=158&ask_summarization=1"},{"index":3,"title":"Pulsuz Paradoks","list":{"type":"unordered","items":["Pulsuz paradoks, perikardiyal tamponatın tanıda önemli bir fizik muayene bulgusudur.","Normalde inspirasyonda sistolik kan basıncı 10 mmHg civarında düşer, ancak tamponatta bu değer 10 mmHg'nin üzerine çıkarak pulsuz paradoks oluşturur.","Pulsuz paradoks, nabızla değil kan basıncı değişikliğiyle ilgilidir ve inspirasyonda radyal nabız alamama durumunda da görülebilir."]},"beginTime":217,"endTime":380,"href":"/video/preview/8351819115135019152?parent-reqid=1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL&text=Health+Ed+Hub&t=217&ask_summarization=1"},{"index":4,"title":"Klinik Görünüm ve Triad","list":{"type":"unordered","items":["Hastalar genellikle taşikardi, ortopne, dispne ve sağ kalp yetmezliği belirtileri (kratibial ödem, hepatit, konjesyon) gösterir.","Tamponatın meşhur triadı: hipotansiyon, kalp seslerinin derinden gelmesi (muffled heart sound) ve juguler venöz dolgunluktur.","Akut hemorolojik tamponatta boyun venöz dolgunluğu olmayabilir çünkü çok akut gelişir ve perikard tanınmadan önce doldurulabilir."]},"beginTime":380,"endTime":511,"href":"/video/preview/8351819115135019152?parent-reqid=1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL&text=Health+Ed+Hub&t=380&ask_summarization=1"},{"index":5,"title":"Tanı ve EKG Bulguları","list":{"type":"unordered","items":["Tamponat klinik bir tanıdır ve kardiyolojinin çağrılması ve eko yapılmasıyla konulur.","EKG'de düşük voltaj, özellikle prekordial derivasyonlarda (V1-V6) görülür.","Taşikardisi ve elektriksel alternans (bir atımdan diğerine QRS morfolojisinin ve voltajının değişmesi) EKG'de görülebilir."]},"beginTime":511,"endTime":605,"href":"/video/preview/8351819115135019152?parent-reqid=1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL&text=Health+Ed+Hub&t=511&ask_summarization=1"},{"index":6,"title":"Görüntüleme Yöntemleri","list":{"type":"unordered","items":["Akciğer grafisinde büyümüş kalp silüeti görülür, bazı durumlarda water bottle (sürahi) şeklinde benzetilir.","Eko ile vena cava inferiorların genişlemesi, sağ atrium ve ventrikülde collaps gelişmesi görülür.","Doppler ile tricuspit ve mitral sitelerinde inspirasyonla beraber artan, aort ve mitral sitelerinde ise azalan velositeler (hızlar) görülebilir."]},"beginTime":605,"endTime":700,"href":"/video/preview/8351819115135019152?parent-reqid=1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL&text=Health+Ed+Hub&t=605&ask_summarization=1"},{"index":7,"title":"Perikardiyal Tamponatın Tanısal Karşılaştırmaları","list":{"type":"unordered","items":["Perikardiyal tamponatın tanıda düşünülmeyecek üç durum vardır: sağ ventriküler miyokard enfarktüsü, konstrüktif perikardit ve restrüktif kardiyomiyopati.","Bu üç durumda kalbin diastolik olarak doluşunu engelleyen mekanizmalar vardır; sağ ventriküler miyokard enfarktüsünde sağ ventrikülün kompliyansı bozulur, konstrüktif perikarditte kalınlaşmış ve kalsifi bir perikard bulunur, restrüktif kardiyomiyopatide ventrikül sert ve genişleyemez.","Bu durumlar perikardiyal tamponatı taklit edebilir, ancak hastanın göğüs ağrısı, EKG değişiklikleri ve kardiyopeptid yükseklikleri tamponata yönlendirir."]},"beginTime":707,"endTime":783,"href":"/video/preview/8351819115135019152?parent-reqid=1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL&text=Health+Ed+Hub&t=707&ask_summarization=1"},{"index":8,"title":"Perikardiyal Tamponatın Tanısal Ayrıştırma","list":{"type":"unordered","items":["Konstrüktif perikardit, tamponattan farklı olarak kusma işareti, belirgin Y inişi ve perikardiyal lok sesi gösterir.","Perikardiyal lok, kalbin her siklusta perikarda çarpmasıyla oluşan spesifik bir sesdir.","Konstrüktif perikardit ve restrüktif kardiyomiyopatide elektriksel alternans ve EFG'de kalp saran perikardtaki kalsifikasyonlar görülür, ancak tamponatta bu bulgular yoktur."]},"beginTime":783,"endTime":865,"href":"/video/preview/8351819115135019152?parent-reqid=1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL&text=Health+Ed+Hub&t=783&ask_summarization=1"},{"index":9,"title":"Kusma İşareti ve Patofizyolojisi","list":{"type":"unordered","items":["Kusma işareti, inspirasyonda negatif intratoraksal basınç artması nedeniyle toraksik kaviteye daha fazla kan çekilmesi ve sağ atriumdaki basınç artışı durumudur.","Bu durumda, normalde kollab olmalı olan boyun venlerinde kan dalgası görülür, bu da kusma işareti olarak adlandırılır.","Kusma işareti restrüktif kardiyomiyopati, konstrüktif perikardit, sağ taraflı miyokard enfarktüsü, trips stenozu, sağ kalp yetmezliği ve masif pulmoner embolizm gibi durumlarda görülebilir."]},"beginTime":865,"endTime":995,"href":"/video/preview/8351819115135019152?parent-reqid=1769581339853754-15557637597395646734-balancer-l7leveler-kubr-yp-klg-159-BAL&text=Health+Ed+Hub&t=865&ask_summarization=1"},{"index":10,"title":"Perikardiyal Tamponatın Tedavisi","list":{"type":"unordered","items":["Perikardiyal tamponat bir acil durumdur ve tanı konulur konulmaz veya şüphe edilirse perikardiyosentez yapılmalıdır.","Perikardiyosentez, iğneyle cilt-tensifoid kısmından perikard boşluğuna girip sıvıyı tamamen boşaltma işlemidir ve EKO kılavuzlu yapılması tercih edilir.","Bazı durumlarda (rekurrent tamponat, lok-e-füzyon) cerrahi drenaj gerekebilir veya perikardtan örnek alınması gerektiği durumlarda cerrahi yaklaşım tercih 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