CV-Pericardial Disease

Question 1

Etiologies of Pericardial Disease

Answer 1

Infxn: VIRAL, bacterial, fungal, TB
Autoimmune: RA, LSA, Dresslers, UREMIA
Trauma: penetrating, Blunt, Aortic Dissection
Cancer: breast, lung, esophageal, lymphoma

Question 2

Pericarditis

Answer 2

Path: Viral, Uremia
Pt: CP = pleuritic and positional 
Dx: 1st: EKG shows PR depressions, diffuse ST elevations
-Best: MRI
Tx: NSAIDs + Colchicine
NSAIDS - CKD, lower platelets, PUD
Colchicine - Diarrhea
F/u: higher recurrence after steroids
-hemodialysis for Uremia

Question 3

Pericardial Effusion

Answer 3

Path: pericarditis
Pt: Pericarditis
Dx: Echo=effusion
Tx: pericarditis
F/u: pericardial window if refractory

Question 4

Pericardial Tamponade

Answer 4

Path: RV cannot fill
Pt: JVD + hypotension+ lower heart sounds (Becks Triad)
- Clear lungs
- Pulsus paradoxus > 10mmHg
Dx: Echo
Tx: Periocardiocentesis (not pericardial window bc too slow)
F/u: IVF in IRL

Question 5

Constrictive Pericarditis

Answer 5

Path: pericarditis
Pt: diastolic CHF
Pericardial knock
Dx: Echo
Tx: pericardiectomy

Question 6

Treatments

Answer 6

Pericarditis: anti-inflammatories
Effusion: pericardial window
Tamponade: pericardiocentesis
Constrictive: pericardiectomy 
F/u: pericardial window if refractory