Pericarditis + Tamponade

Question 1

1. What are the symptoms of acute pericarditis?
2. What may you find on auscultation for acute pericarditis?
3. What are causes of acute pericarditis?
4. What may you find on ECG?
5. How do you management acute pericarditis?

Answer 1

1. Pleuritic chest pain, improved on leaning forwards. Non-productive cough, flu-like symptoms, tachypnoea, tachycardia
2. Pericardial rub
3. Viral, i.e. Cocksackie, TB, Trauma, Post-MI, HypoT, malignancy, uraemia, connective tissue disorders
4. Widespread saddle shaped ST elevation, PR depression
5. Colchicine and NSAIDs

Question 2

1. What signs you find on constrictive pericarditis?
2. What cause is particularly associated with constrictive pericarditis?
3. What may you see on CXR?

Answer 2

1. Signs of Right heart failure, so elevated JVP. Oedema, hepatosplenomegaly, ascitis. Pericardial knock, S3 sound. Kaussmall’s sign (rise in JVP in inspiration). JVP shows X and Y descent
2. Tuberculosis
3. Pericardial calcification on CXR

Question 3

CARDIAC TAMPONADE

1. What is Cardiac Tamponade?
2. What are the 3 main features?
3. What is the JVP of Cardiac Tamponade?
4. Is Pulsus Paradoxus present?
5. Is Kausmall breathing present? What is it?
6. What is the management?

Answer 3

1. An accumulation of pericardial fluid under pressure
2. Beck’s triad: Rise in JVP, muffled heart sounds, hypotension
3. TampaX - only X present, absent Y descent
4. YES
5. NO, rise in JVP on breathing
6. Pericardialcentesis

Question 4

CONSTRICTIVE PERICARDITIS

1. What is the JVP of Constrictive Pericarditis?
2. Is Pulsus Paradoxus Present?
3. Is Kausmall Breathing present? What is it?
4. What may you hear on auscultation?
5. What may you see on CXR?

Answer 4

1. X and Y is present
2. NO
3. YES, rise in JVP on breathing
4. Pericardial knock, Loud S3
5. Pericardial calcification