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Cardio II Midterm > Pericardial Disease > Flashcards

Flashcards in Pericardial Disease Deck (15)
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Clinical signs of pericardial effusion and hemopericardium

Chronic: seen on Xray as globular enlargement of the heart shadow

Hemoperricardium can cause cardiac tamponade very quickly if there is a ruptured MI or aortic dissection


Pathogenesis of pericardial effusion and hemopericardium

Pericardial effusion: filled with serous fluid
Hemoperricardium: filled with blood
Purulent pericarditis: filled with pus

Slow accumulating fluid, pericardium has time to dilate and can become quite large


Normal pericardial sac contents

less than 50 mL of thin, clear, straw-colored fluid


Clinical signs of acute pericarditis

Fibrinous: pain, fever, possible CHF
Friction rub most striking

Constrictive: heart sounds are muffled, heart can't increase workload for demands due to its restriction


Pathogenesis of serous pericarditis

Rheumatic fever, SLE, scleroderma, tumors, uremia

Bacterial pleuritis may cause sterile serous effusion in pericardium

URI, pneumonia, parotitis may be the primary site of infection


Pathogenesis of Fibrinous and serofibrinous pericarditis

most frequent types. Serous fluid with a fibrinous exudate. Acute MI, postinfarction syndrome, uremia, chest radiation, rheumatic fever, SLE, and trauma. Follows routine surgery


Pathogenesis of purulent pericarditis

active infection by microbial invasion from direct extension, seeding, lymphatic, direct introduction. Serosal surfaces are reddened, granular, and coated w/ exudate.


Pathogenesis of hemorrhagic pericarditis

exudate of blood and fibrinous or suppurative effusion from malignancy to this space. Can also be from infection. W/ bleeding disorder, may follow surgery. Causes a re-operation.


Pathogenesis of caseous pericarditis

Tuberculosis in origin. Direct spread from bronchial tree.


Serous pericarditis histology

mild inflammatory infiltrate in the epipericardial fat


Fibrinous pericarditis morphology

dry surface w/ fine granular roughening


Serofibrinous pericarditis morphology

accumulation of larger amounts of yellow to brown turbid fluid


Constrictive pericarditis morphology

Organization w/ scarring

encased in a dense, fibrous or fibrocalcific scar. Limits the expansion. Up to a cm thick. Can resemble plaster (concetio cordis)


Chronic/healed pericarditis morphology

“soldiers” plaque in the pericardium or mesh like adhesions causing adhesive pericarditis.


Adhesive mediastinopericarditis

follow infection, previous cardiac surgery or mediastinal irradiation. Pericardial sac is destroyed. Heart pulls against the pericardium but also the mediastinal structures causing pulsus paradoxus