Pericardial disease + aneurysm Flashcards Preview

Year 3 Cardiology > Pericardial disease + aneurysm > Flashcards

Flashcards in Pericardial disease + aneurysm Deck (17)
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1
Q

Pathophysiology of pericarditis

A

Inflammation of the pericardium

Often preceded by an URTI

2
Q

Presentation of pericarditis

A
Pain worse when lying flat 
Relieve when lying forward 
Pericardial rub on auscultation 
Pleuritic chest pain
Fever
3
Q

Investigations of pericarditis

A

Bloods - Troponin I, LFTs, U+Es, CRP, FBC
ECG - saddle shaped ST
Transthoracic echocardiogram
CXR - check for pericardial effusion

4
Q

ECG changes of pericarditis

A

Saddle shaped ST segment
PR depression
Reciprocal ST depression and PR elevation in AVR and V1

5
Q

Management of pericarditis

A
  • self limiting normally
  • treat underlying cause such as uraemia
  • colchicine - 3 months with gastric protection
6
Q

Aneurysm presentation

A
  • 4-6wk
  • Angina
  • Recurrent VT
  • Systemic emboli

ECG: can show persistent ST elevation

7
Q

Mx of aneurysm

A
  • Anticoagulate

* Consider Excision

8
Q

Dressler’s Syndrome

A

Pericarditis 2 - 6 wks after MI or heart surgery do to auto-immune cause

9
Q

Causes of pericarditis

A
Viral: coxsackie, flu, EBV, HIV
Bacterial: pneumonia, rheumatic fever, TB, staphs
Fungi
MI, Dressler’s
Drugs: penicillin, isoniazid, 
Other: uraemia, RA, SLE
10
Q

Pericardial effusion

A

Any cause of pericarditis

11
Q

Features of pericardial effusion

A
  • Dyspnoea
  • ↑JVP
  • Bronchial breathing at left base
12
Q

Pericardial effusion on CXR

A

Meniscus

Shadowing of costophrenic angles

13
Q

Mx of pericardial effusion

A

Treat cause
Pericardiocentesis may be diagnostic or therapeutic

Culture- ZN stain and cytology

14
Q

Acute Myocarditis

A

Idiopathic
Viral: coxsackie B, flu, HIV
Bacterial: S. aureus, syphilis
Drugs: cyclophosphamide, Herceptin, phenytoin
Autoimmune: Giant cell myocarditis assoc. with SLE

15
Q

Symptoms of acute myocarditis

A

Flu-like prodrome: fever, sore throat, myalgia
Dyspnoea, fatigue
Chest pain
Arrhythmia → palpitations

16
Q

Investigations for acute myocarditis

A
Ix
ECG:
- ST-elevation or depression
- T wave inversion
- Transient AV block

Bloods: +ve trop, ↑CK

17
Q

Acute myocarditis tx

A

Supportive

Tx cause