Flashcards in Cardiology Deck (560)
What is pericarditis?
inflammation of the pericardium which is the protective covering of the heart
What are the two layers of the pericardium?
outer fibrous and inner serous
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
What are the 3 types of pericarditis?
acute and relapsing
pericardial effusion and cardiac tamponade
What is the pain like in pericarditis?
sharp central pleuritic chest pain, can spread to neck or shoulders
What exacerbates the pain in pericarditis?
movement, coughing, breathing, lying down
What is pericarditis relieved by?
sitting up and leaning forward
What other symptoms are associated with pericarditis?
fever, chills, dyspnoea, pericardial friction rub, cardiac tamponade
What is a pericarditis friction rub?
a cardiac rub or leathery sound that is heard on examination
What does an ECG show in pericarditis?
IN ALL LEADS BUT aVR WHICH WILL BE OPPOSITE
(different to MI elevation which is limited to infarcted area)
What will a CXR show in pericarditis?
What will an ECHO show in pericarditis?
may show effusion
What will a CT and MRI show is pericarditis?
What is the treatment of pericarditis?
aspirin if recent MI
colchicine (before steroids to reduce recurrence)
corticosteroids if resistant or immune cause
How common is relapsing in pericarditis?
20% of acute cases relapse
What is a pericardial effusion?
a collection of fluid with space of the serous pericardial which accompanies acute
What does pericardial effusion cause?
cardiac tamponade, poor ventricular filling and reduced cardiac output, pericarditis
What is the treatment of pericardial effusion?
What are the symptoms of pericardial effusion?
soft distant, dysponea
What happens in chronic pericarditis?
the subepicardial layers of myocardium may undergo fibrosis, atrophy and calcification causing a rigid pericardium
What will a CXR show in chronic pericarditis?
small heart with pericardial calcification
What will an ECG show in chronic pericarditis?
low QRS, flattened T wave
What will an ECHO show in chronic pericarditis?
thickened calcification pericardium, small ventricle cavities with thickened walls
Why would you do an endomyocardial biopsy in chronic pericarditis?
to distinguish it from restrictive myopathy
What is the treatment of chronic pericarditis?
pericardectomy if no TB
if TB, antiTB drugs then pericardectomy
What is a true aneurysm?
Where all the layers of the vessel dilate together
What is the difference between a fusiform and berry (saccular) aneurysm?
A fusiform is symmetrical in its dilation but a berry is asymmetrical
What causes an asymmetrical aneurysm?
one side of the blood vessel has had a higher pressure, or one side of the wall was weaker?
What are the two types of true aneurysm?
fusiform and saccular