Heart Related Diseases

Question 1

What is pericardial disease

Answer 1

Infection due to pericardial layer due to any cause

Question 2

What are types of pericardial diseases

Answer 2

Pericarditis
Pericardial effusion
Cardiac tamponad
Constructive pericarditis
Congenital abnormalities
Pericardial cyst

Question 3

What two layers does pericardium consist of

Answer 3

Most inner later - serous visceral layer

Most outer layer - fibrous parietal layer

Question 4

What is the function of the pericardial layer

Answer 4

Maintaining cardiac shape
Promoting cardiac interaction
Preventing overfilling of heart
Reduced friction between heart and adjusted organs
Physical barrier to contagious infection from the lung

Question 5

What is the pressure range of pericardial layer

Answer 5

0-3 mmhg

Question 6

How much fluid does the pericardial space have

Answer 6

15-30 mm

Question 7

What is acute pericarditis

Answer 7

Infiltration of inflammatory cells into pericardium

Question 8

What are the causes of acute pericarditis

Answer 8

Primary disease - heart related disease

Secondary disease - any other organ that causes pericardium and heart to get damaged mainly kidney and liver

Systemic illness - whole body getting infected. For example lupus, cancer, tumor, myocardial infarction

Question 9

What’s more common - acute or chronic pericarditis

Answer 9

Acute pericarditis

Question 10

What are the criteria for acute pericarditis

Answer 10

At least two needed :

Chest pain
Pericardial friction rub - when two layers of the pericardial layer rubbing against each other

EKG changes - ST elevation

Worsening of pericardial effusion

Question 11

What are the complications of acute pericarditis

Answer 11

Pericardial effusion
Cardiac tamponad
Constrictive pericarditis

Question 12

What is pericardial effusion

Answer 12

Abnormal accumulation of fluid in pericardial cavity greater than 50ml

Question 13

What causes pericardial effusion

Answer 13

Injury of pericardium
Hypothyroidism
Renal disease
Cancer

Question 14

What’s the echo finding of pericardial effusion

Answer 14

Excessive swinging motion of the heart within the fluid sac

Question 15

What are the differential diagnosis of pericardial effusion

Answer 15

Epicardial fat tissue
Left pleural effusion

Coronary sinus
Descending aorta
Acitysis
Heavy mineral annulas pacification

Question 16

What are the views you see pericardial effusion

Answer 16

PLAX
subcostal
Short axis papillary muscle

Question 17

Severity of pericardial effusion table

Answer 17

Small:
Volume - 50-100
Localization: posterior/lateral
Width: less than 1.0 cm

Moderate:
Volume - 100-500
Localization : circumferential
Width: 1-2 cm

Severe:
Volume - more than 500
Localization : circumferential
Width- more than 2cm

Question 18

What is cardiac tamponad

Answer 18

Elevation of pericardial pressure
Causing intrapericardial pressure to increase which causes diastolic function
Fluid should be more than 100 ml

Question 19

What are the causes of cardiac tamponad

Answer 19

Large and uncontrolled pericardial effusion

Trauma
Myocardial rupture
Cancer
Pericarditis
Cardiac surgery

Question 20

What is the pathophysiology of pericardial effusion

Answer 20

The outer pericardium stretches
The fluid begins entering the pericardial space
Pressure starts to increase

Question 21

What’s the outcome of cardiac tamponad

Answer 21

Increase systemic venous pressure
Equal diastolic pressure in all 4 chambers
RV diastolic collapse
Decreased cardiac output

Question 22

Echo findings of cardiac tamponad

Answer 22

Pericardial rub
Pericardial effusion
Dilated IVC
RV collapse
Abnormal respiratory changes more than 30%
Elevated jugular venous pressure
Tachycardia
Diastolic dysfunction

Question 23

Treatment for cardiac tamponad

Answer 23

Oxygen
Cathader pericardial synthesis
Pericardialectomy

Question 24

What is constrictive pericarditis

Answer 24

Thick and calcified pericardium that causes diastolic dysfunction

Question 25

What are the causes of constrictive pericarditis

Answer 25

Viral pericarditis Surgery Collagen vascular disease Radiation

Question 26

What is the pathophysiology of constrictive pericarditis

Answer 26

``` Elevated and equalized cardiac pressure Fibrotic pericardium Increase pulmonary pressure Diastolic dysfunction Lower output ```

Question 27

What's the signs of constrictive pericarditis

Answer 27

``` Swollen abdomen in lower extremities Increase in jugular vein Kussmauls sign Pericardial knock (3rd heart sound ) Pulses peridoxis ```

Question 28

What are the echo findings of constrictive pericarditis

Answer 28

``` Pericardial thickening Septal bounce IVC dilation Heart failure MV inflow dysfunction Respiratory changes Normal TDI ```

Question 29

Treatment for constrictive pericarditis

Answer 29

Bypass surgery | Removing the pericardium

Question 30

Pleural effusion position where to the DTA

Answer 30

Posterior

Question 31

Pericardial effusion where to the DTA

Answer 31

Anterior

Question 32

What are the symptoms of pericarditis?

Answer 32

``` Chest pain Shortness of breath Acitysis Leg swelling Hypotension ```