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1

What is pericarditis?

inflammation of the pericardium which is the protective covering of the heart

2

What are the two layers of the pericardium?

outer fibrous and inner serous

3

What are the causes of pericarditis?

idiopathic, virus e.g. Coxsackie B or echovirus, trauma, post MI, TB, fungal, malignant, uraemic from accumulating toxins, pericardial effusion

4

What are the 3 types of pericarditis?

acute and relapsing
pericardial effusion and cardiac tamponade
constrictive pericarditis

5

What is the pain like in pericarditis?

sharp central pleuritic chest pain, can spread to neck or shoulders

6

What exacerbates the pain in pericarditis?

movement, coughing, breathing, lying down

7

What is pericarditis relieved by?

sitting up and leaning forward

8

What other symptoms are associated with pericarditis?

fever, chills, dyspnoea, pericardial friction rub, cardiac tamponade

9

What is a pericarditis friction rub?

a cardiac rub or leathery sound that is heard on examination

10

What does an ECG show in pericarditis?

ST elevation
PR depression
IN ALL LEADS BUT aVR WHICH WILL BE OPPOSITE
(different to MI elevation which is limited to infarcted area)

11

What will a CXR show in pericarditis?

cardiomegaly

12

What will an ECHO show in pericarditis?

may show effusion

13

What will a CT and MRI show is pericarditis?

inflamed pericardium

14

What is the treatment of pericarditis?

NSAIDs
aspirin if recent MI
colchicine (before steroids to reduce recurrence)
corticosteroids if resistant or immune cause

15

How common is relapsing in pericarditis?

20% of acute cases relapse

16

What is a pericardial effusion?

a collection of fluid with space of the serous pericardial which accompanies acute

17

What does pericardial effusion cause?

cardiac tamponade, poor ventricular filling and reduced cardiac output, pericarditis

18

What is the treatment of pericardial effusion?

pericardial drainage

19

What are the symptoms of pericardial effusion?

soft distant, dysponea

20

What happens in chronic pericarditis?

the subepicardial layers of myocardium may undergo fibrosis, atrophy and calcification causing a rigid pericardium

21

What will a CXR show in chronic pericarditis?

small heart with pericardial calcification

22

What will an ECG show in chronic pericarditis?

low QRS, flattened T wave

23

What will an ECHO show in chronic pericarditis?

thickened calcification pericardium, small ventricle cavities with thickened walls

24

Why would you do an endomyocardial biopsy in chronic pericarditis?

to distinguish it from restrictive myopathy

25

What is the treatment of chronic pericarditis?

complete resection
pericardectomy if no TB
if TB, antiTB drugs then pericardectomy

26

What is a true aneurysm?

Where all the layers of the vessel dilate together

27

What is the difference between a fusiform and berry (saccular) aneurysm?

A fusiform is symmetrical in its dilation but a berry is asymmetrical

28

What causes an asymmetrical aneurysm?

one side of the blood vessel has had a higher pressure, or one side of the wall was weaker?

29

What are the two types of true aneurysm?

fusiform and saccular

30

What is a false aneurysm?

caused by a hole in vessel causing it to leak forming a pool due to the surrounding tissue keeping it in place so it looks like an aneursym