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Flashcards in PERICARDIAL DISEASES Deck (26):
1

a double-walled sac containing the heart and the roots of the great vessels.

Pericardium

2

If the Pericardium Cavity becomes full of fluid it will compress the heart and lead to

pericardium tamponade

3

ACUTE PERICARDITIS

Sudden onset CP (severe)
CP varies with position and breathing

Pericardial rub on cardiac exam
EKG- Diffuse ST elevation

4

ACUTE PERICARDITIS COMMONEST CAUSES:

1. Viral illness
2. Connective tissue or autoimmune diseases
3. Uremia
4. Metastatic tumors

5

__________ is a type of pericarditis (an inflammation of the sac surrounding the heart, the pericardium) usually lasting < 6 weeks. It is the most common condition affecting the pericardium.

Acute pericarditis

6

ACUTE PERICARDITIS Responds to:

anti-inflammatory agents
(Ibuprofen, aspirin)
*colchicine

7

PERICARDIAL EFFUSION

occurs when too much fluid builds up around the heart.

8

PERICARDIAL EFFUSION
Common Causes

1. Viral or acute idiopathic pericarditis
2. Metastatic malignancy
3. Uremia
4. Autoimmune Disease
5. Hypothyroidism

9

Small effusions without high intrapericardial
pressure may be asymptomatic

Large effusions with high intrapericardial pressures cause ___________ where myocardial compression impairs diastolic filling

cardiac tamponade

10

PERICARDIAL EFFUSION WITH
TAMPONADE CAUSE

Rapidly accumulating moderate sized or large
effusions

11

Pericardial effusion with _____________ is called cardiac tamponade

enough pressure to adversely affect heart function

12

PERICARDIAL EFFUSION WITH
TAMPONADE PRESENTATION

Decreased RV diastolic filling during inspiration

Distended neck veins

Inspiratory decrease in arterial pressure
(Paradoxical Pulse)***

13

ECHOCARDIOGRAM IN TAMPONADE

• Collapse of the right atrium and right ventricle in end-diastole
• Dilation of the inferior vena cava without
the normal >50% reduction during inspiration

14

ECG IN CARDIAC TAMPONADE

Low voltage with sinus tachycardia
Electrical alternans with sinus tachycardia

15

CONSTRICTIVE PERICARDITIS is a ____ disease

Chronic

16

CONSTRICTIVE PERICARDITIS CAUSE

Scarring & loss of elasticity of the pericardium

17

CONSTRICTIVE PERICARDITIS ETIOLOGIES

Idiopathic, after cardiac surgery, radiation, infectious (TB)

18

CONSTRICTIVE PERICARDITIS PATHOPHYSIOLOGY

Impaired diastolic filling with normal systolic function

19

CONSTRICTIVE PERICARDITIS PRESENTATION

Markedly elevated jugular venous pressure**, tachycardia
Often with hepatomegaly,edema, ascites

20

DIAGNOSIS OF CONSTRICTIVE
PERICARDITIS

Transthoracic echo- see pericardial thickening
MRI/CT- Calcified Pericardium
Cath

21

CATHETERIZATION IN CONSTRICTIVE PERICARDITIS

1. Dip and Plateau (“square root sign”) during diastole.
2. Equalization of diastolic pressures between LV and RV.

22

A chronic disease that usually takes:

considerable time to develop

23

Cardiac silhouette usually __________but encased by thickened pericardium

normal size

24

Lungs not congested because constriction selectively impairs _____________

filling of right ventricle

25

Cousmals sign

deep inspiration-->
Bulge/Inc in Venous Pressure on Right Side JVD
NO paradoxical pulse (where LV affected)

26

CONSTRICTIVE PERICARDITIS Treatment:

Surgical stripping of the pericardium