Pericardial Disease Flashcards
(25 cards)
What are the common causes of Pericarditis?
Infection
Inflammatory Disorder
CT Disorder
Chest Trauma
Cancer of an organ near the heart
What is a potential complication of Pericarditis with extravasation of fluid?
Tamponade
What is a potential complication of chronic Pericarditis?
Patients can develop fibrosis and calcification of the pericardium leading to constrictive pericarditis
What is the most common infectious cause of Pericarditis?
Viral Infections
-others to note: Staph, Strep, Fungi
What is the most common Connective Tissue Disorder associated with Pericarditis?
SLE
-others to note: Wegener Granulomatosis, Goodpasture, RA, PAN
What clinical feature is most often associated with Pericarditis?
Sharp chest pain that is worse with lying flat and breathing
-improved with sitting up
What sound is commonly auscultated in Pericarditis?
Scratchy friction rub
What changes are seen on EKG in Pericarditis?
Diffuse ST segment elevation and PR segment depression
What is the most specific EKG finding in Pericarditis?
PR segment Depression
What are the treatment options for Pericarditis?
Treat the underlying cause
NSAID + Colchicine
If contraindication to NSAID/no improvement use Steroids
What is the role of Colchicine in Pericarditis?
Decreased recurrence
What side of the heart is compressed first in Pericardial Tamponade?
The right side: because the walls are thinner
What clinical features point to Pericardial Tamponade as the most likely diagnosis?
Hypotension
Tachycardia
Distended Neck veins
Clear lungs
What are the diagnostic tests for Pericardial Tamponade?
EKG
CXR
Echocardiogram
Right heart catheterization
What is seen on EKG in Pericardial Tamponade?
Electrical Alterans: different heights of QRS between beats
What is seen on CXR in pericardial Tamponade?
Enlarged cardiac shadow expanding in both directions “Globular heart”
What is seen on Echocardiogram in Pericardial Tamponade?
Right atrial and ventricular diastolic collapse
What is seen on Right Heart Catheterization in Pericardial Tamponade?
Equalization of pressure in diastole
What are the treatment options in Pericardial Tamponade?
Pericardiocentesis: needle drainage to rapidly re-expand the heart
IVF
Pericardial window for recurrent cases
What is Constrictive Pericarditis?
Calcification and fibrosis of the pericardium prevents filling of the right side of the heart
What are some common physical exam findings in Constrictive Pericarditis?
Kussmaul Sign: increase in JVD on inhalation
Knock: extra heart sound in diastole from ventricular filling
-heart fills to its max hitting the stiff pericardium with a “knock”
What exam findings point to constrictive pericarditis as the most likely diagnosis?
Signs of Right Heart Failure: Edema, Ascites, JVD, enlarged Liver/Spleen
What is the best initial test for Constrictive Pericarditis?
CXR showing calcification and fibrosis
What is the most accurate test for Constrictive Pericaritis?
CT and MRI: only done after CXR
