A 56-year-old man presents with cardiac tamponade (BP 92/58, HR 128, RR 22, SpO2 94%). Echocardiography reveals a large pericardial effusion with right atrial collapse. He denies recent chest trauma. He takes aspirin daily for coronary artery disease. Emergency pericardiocentesis is performed using a parasternal approach through the left fifth intercostal space adjacent to the sternum. Which of the following structures is most at risk of inadvertent injury with this anatomic approach?
- A)Internal thoracic arteryGABARITO
- B)Thoracic duct
- C)Phrenic nerve
- D)Vagus nerve
- E)Intercostal artery
Explicação
The internal thoracic artery descends vertically along the inner anterior thoracic wall just lateral to the sternum. Parasternal procedures such as pericardiocentesis can injure this vessel if the needle is placed too close to it. Ver explicação completa e trilha adaptativa →