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Flashcards in Pericardial Disease Deck (43):
0

Jugular venous exam finding in tamponade

Blunted or absent y descent

1

Hemodynamic findings in tamponade

Equalization of LV and RV pressures

2

If pt has breast CA, what cardiac issues should you think of?

CM, constriction or tamponade

3

Where can pericarditis pain radiate to?

Trapezius

4

What is the yield of serologic studies in acute pericarditis?

Low

5

COPE trial results for acute pericarditis

Colchicine reduced recurrence rates vs placebo

6

2 side effects of colchicine

Diarrhea
Bone marrow suppression

7

Can colchicine be given in renal or hepatic dysfxn?

No

8

In what case are colchicine's side effects pronounced?

Interaction with CYP3A4 drugs (CCB, Amio, cyclosporine)

9

Steroids should be avoided in acute pericarditis unless ...?

Contraindications to colchicine
Connective tissue dz
Uremic pericarditis

10

Diagnostic criteria for post-pericardiotomy syndrome?

2 of the following:
Pleuritic CP, friction rub, pleural effusion, new or worsening pericardial effusion, fever > 1wk postop

11

Definition of myopericarditis

Elevation of cardiac enzymes or new LV dysfxn

12

What population is prone to get myopericarditis?

Male age<40

13

definition of pulsus paradoxus (Tamponade)

inspiratory decrease in SBP >10

14

what causes false positive results for pulsus paradoxus, making you think there is tamponade?

COPD, PE, constriction

15

what causes false negatives for pulsus paradoxus?

LVH, AI, ASD, vent, localized effusion, severe hypotension

16

Rx of tamponade

IVF, inotropes/vasopressors if hypotension persists, pericardiocentesis, avoid vent

17

what is appearance of Y-descent in constrictive pericarditis?

prominent

18

inc'd RAP, prominent y-descent, tachycardia. Most likely Dx?

constrictive pericarditis

19

description of constrictive pericarditis

obliterated pericardial space and adhesive pericarditis

20

top 5 etiologies behind constrictive pericarditis

idiopathic, prioir cardiac Sx, pericarditis, mediastinal radiation, CTD

21

what sxs will pt get in constrictive pericaditis if RA = LA are 10mmHg?

hepatomegaly, edema

22

what sxs will pt get in constrictive pericaditis if RA = LA are > 18mm Hg?

dyspnea, orthopnea

23

what stage of cardiac cycle do restrictive and constrictive CM effect mainly?

diastole

24

what is the systolic function (usually) in constriction or restriction?

normal

25

what is the Kussmaul sign and what dz state is it seen in?

-elevated JVP on inspiration
-constrictive pericarditis

26

what is Friedrich's sign and what dz state is it seen in?

-prominent Y descent
- constrictive pericarditis

27

what do you see on mitral and tricuspid inflow velocities on echo (E wave) in constrictive pericaditis?

respiratory flow variation

28

on echo in constrictive pericarditis, what is the septum doing?

diastolic bounce

29

what do the atria look like on echo in constrictive pericarditis?

dilated despite TR/MR

30

what is an abnormal pericardial thickness?

>4mm

31

ventricualr interdependence

constriction

32

what is the PASP usually in constrictive pericarditis? restrictive?

constrictive PASP < 50
Restrictive PASP > 80

33

the number one reason to suspect constriction

LV/RV interdependence

34

what pattern will MV inflow have on echo in constrictive pericarditis?

restrictive pattern

35

3 factors that deme a worse prognosis s/p pericardiectomy for constriction

age, NYHA class, post-radiation as cause

36

First line agents to treat acute pericarditis

NSAIDs and colchicine

37

when do you give corticosteroids for acute pericarditis? why?

-refractory cases or contraindications to first line therapy
-b/c of higher rate of recurrent pericarditis

38

dissociation of intra-thoracic and intra-cardiac pressures

constrictive pericarditis

39

what is LVEDP-RVEDP in constriction?

<5mmHg

40

what is PASP in constriction?

<55mmHg

41

RVEDP/RVSP in constriction

> 1/3

42

if LVEDP-RVEDP > 5mmHg and RVEDP/RVSP < 1/3 and PASP > 55, is it constriction or restriction?

restriction