Pericardial Disease Flashcards

1
Q

What is the difference between acute pericarditis, Constrictive Pericarditis and Cardiac Tamponade?

A

Acute pericarditis = Inflammation of the pericardium

Constrictive Pericarditis = Fibrosing of the pericardium leading to the heart being encased in a rigid sac

Cardiac Tamponade = Increase in pericardial fluid -> Increase in intrapericardial pressure -> Lower ventricle filling and reduced Cardiac Output

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2
Q

What causes acute pericarditis?

A

Idiopathic
Trauma/Surgery
Bacterial Infection (incl. Rheumatic Fever)
Viral or fungal infection
SLE
MI
Malignancy

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3
Q

How does acute pericarditis present?

A

Central Chest Pain
Pericardial Rub
~ Fever

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4
Q

HOw do we test for acute pericarditis?

A

ECG - Saddle shaped (concave) ST elevation
CXR - May show a pericardial effusion (follow with ECHO)
Bloods - FBC, ESR, U+E, Cardiac enzymes e.g. troponin
Blood cultures & Viral Serology

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5
Q

How do we treat acute pericarditis?

A

With analgesia and by treating the cause
Can also drain the effusion if necessary (pericardiocentesis)

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6
Q

What causes constrictive pericarditis?

A

Often unkown - TB - Post-pericarditis

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7
Q

How does constrictive pericarditis present?

A

Fatigue - Dyspnoea - weakness - Peripheral Oedema (symptoms of RHF)
Raised JVP - Ascites (abdominal swelling) - quiet heart sounds

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8
Q

How do we test for constrictive pericarditis?

A

CXR = May see small heart and calcification
CT/MRI - IF CXR unclear
ECHO
Cardiac Catherterisation

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9
Q

How do we treat constrictive pericarditis?

A

Surgical Excision

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10
Q

What causes cardiac tamponade?

A

Aortic Dissection
Any pericarditis
Warfarin
Surgery gone wrong

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11
Q

How does cardiac tamponade present?

A

Cardiogenic Shock: Dizziness - Weakness/collapse - Dyspnoea - Cough
Central Chest Pain
Increased HR - Drop in BP - Raised JVP - Muffled Heart Sounds

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12
Q

How do we diagnose Cardiac Tamponade?

A

Clinically: Becks Triad (Muffled Heart Sounds, Raised JVP and drop in BP)
CXR: Over 250ml will show a big globular heart
ECG: Low voltage QRS complexes
ECHO: Larger pericardium +/- collapsed ventricles (mainly right heart in diastole)
Aspirate some fluid and send for M,C & S

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13
Q

How do we treat Cardiac Tamponade?

A

Treat the Cause
Drain the fluid (pericardiocentesis)

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