Pericardial Tamponade & Pericardiocentesis Flashcards Preview

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Flashcards in Pericardial Tamponade & Pericardiocentesis Deck (18):
1

3 Pericardial Compression Syndromes

Cardiac tamponade
Constrictive pericarditis
Effusive-constrictive percarditis

2

Define Cardiac Tamponade

Accumulation of pericardial fluid under pressure and may be acute or subacute

3

Define Constrictive Pericarditis

Scarring and consequent loss of elasticity of the pericardial sac

4

Define Effusive-Constrictive Pericarditis

Constrictive physiology with a coexisting pericardial effusion

5

How does cardiac tamponade effect cardiac output?

Increased pressure in the pericardium exceeds ventricular pressure impairing diastolic compliance reducing cardiac filling

6

Acute Pericardial Effusion

Pericardium has no time to adjust
Small volume of fluid can cause tamponade

7

Insidious Pericardial Effusion

Pericardial compliance increases allowing a larger volume of fluid into sac

8

Causes of Pericardial Tamponade

Malignancy
HIV infection
Infection
Drugs
Post-coronary intervention
Trauma
CV surgery
Post-MI
CT diseases
Radiation therapy
Iatrogenic
Uremia
Idiopathic pericarditis
Complication of surgery at EJ junction
Pneumopericardium

9

Define Uremia

High levels of urea in the blood from kidney failure

10

Symptoms of Pericardial Tamponade

Dyspnea
Tachycardia
Tachypnea
Cold, clammy extremities
Weight loss, fatigue, anorexia
Chest pain
Joint pain
Renal failure
Medications
Recent procedure
TB
Radiation

11

Beck's Traid

Increased JVP
Hypotension
Diminished heart sounds

12

Physical Exam Findings

Beck's Triad
Hepatomegaly
Evidence of chest wall trauma
Pulsus paradoxsus
Kussmaul sign
Abolished y descent

13

Diagnostics of Pericardial Tamponade

EKG: electrical alternans, ST
CXR: enlarged cardiac silhouette
Echo: effusion, diastolic collapse, LV pseudohypertrophy
Right heart cath: measure right sided pressures

14

Treatment of Cardiac Tamponade

Surgery: pericardiocentesis or pericardial window
Oxygen
Volume expansion
Bed rest with leg elevation
Inotropic drugs

15

Describe a Pericardial Window

Surgical opening of a communication between the pericardial space and the intracellular space

16

Treatment for Recurrent Effusion

Pericardectomy
Pericardial-peritoneal shunt
Pericardiodesis

17

Describe Pericardiodesis

Steroids, tetracycline, or antineoplastic drugs can be instilled into the pericardial space sclerosing the pericardium

18

Definitive Therapy for Removing Excessive Fluid from Around the Heart

Pericardiocentesis