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Z Year3 Cardio Conditions > Pericarditis > Flashcards

Pericarditis Flashcards

(46 cards)

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1
Q

What is pericarditis?

A

inflammation of pericardium (fluid filled sac around heart)

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2
Q

What are the different types of pericarditis?

A
  1. Acute pericarditis
  2. Pericardial effusion
  3. Constrictive pericarditis
  4. Cardiac tamponade
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3
Q

What are the inflammatory causes of pericarditis?

A
  1. Post-MI (1-3 days)
  2. Dressler’s syndrome (weeks months)
  3. Systemic (SLE, sarcoidosis)
  4. Trauma
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4
Q

What are the infection causes of pericarditis?

A
  • Mostly viral:
    1. Coxsackie B / A9
    2. Echovirus
    3. Mumps
  • TB in developing countries
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5
Q

What are the malignancy causes of pericarditis?

A
  1. Malignancy
  2. Radiotherapy
  3. Anti-cancer drugs
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6
Q

What are causes of acute pericarditis?

A
  1. Idiopathic
  2. Viruses: EBV, CMV
  3. Bacteria: TB
  4. Fungi and parasitic
  5. Autoimmune: SLE, RA
  6. Drugs
  7. Metabolic
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7
Q

What are RF for acute pericarditis?

A
  1. Male
  2. 20-50
  3. Transmural MI
  4. Cardiac surgery
  5. Neoplasm
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8
Q

What is chronic pericarditis?

A

chronic inflammation of the pericardium with thickening and scarring

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9
Q

What are causes of chronic pericarditis?

A
  1. Idiopathic
  2. Infectious (TB, Bacterial, Viral)
  3. Acute pericarditis
  4. Cardiac surgery and radiation
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10
Q

What is a pericardial effusion?

A

accumulation of fluid in pericardial sac

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11
Q

What are causes of pericardial effusion?

A
  1. Pericarditis
  2. Myocardial rupture
  3. Aortic dissection
  4. Malignancy
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12
Q

What is cardiac tamponade?

A

Pericardial effusion that raises intrapericardial pressure, reduced ventricular filling and so dropping cardiac output – can lead to cardiac arrest

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13
Q

What are RF for cardiac tamponade?

A
  1. Aortic dissection
  2. Purulent pericarditis
  3. Large idiopathic pericardial effusion
  4. TB
  5. Malignancy
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14
Q

What is the patho of cardiac tamponade?

A

fluid build up in pericardium restricts heart pumping

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15
Q

What is the normal epid for pericarditis?

A

Male 20-50yo

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16
Q

What is the key symptom of pericarditis?

A

pleuritic chest pain

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17
Q

What is the key sign of pericarditis?

A

pericardial friction rub

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18
Q

What are symptoms of acute pericarditis?

A
  1. Chest pain is sharp and central
  2. RELIEVED BY SITTING UP & LEANING FORWARD
  3. fever
  4. dyspnoea
  5. nausea
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19
Q

What is perciardial friction rub?

Study These Flashcards
A
  1. Scratchy sound
  2. Heard at left sternal edge w/ patient leaning forward on expiration
  3. Use diaphragm of stethoscope
20
Q

What are symptoms and signs of chronic pericarditis?

Study These Flashcards
A
  • similar to restrictive cardiomyopathy
    1. RHF presentation (raised JVP, oedema)
    2. Kussmaul’s sign
    3. Diffuse apex beat
    4. S3
21
Q

What are symptoms of pericardial effusion?

Study These Flashcards
A
  1. Dyspnoea
  2. Chest pain
  3. Signs of local structures compressed e.g. nausea, hiccoughs, muffled heart sounds
22
Q

What are symptoms and signs of cardiac tamponade?

Study These Flashcards
A
  1. High pulse
  2. Low BP
  3. Pulsus paradoxus
  4. High JVP
  5. Kussmauls’s signs
  6. Muffled S1 and S2
23
Q

What is Beck’s triad for cardiac tamponade?

Study These Flashcards
A
  1. Distended neck veins
  2. Decreased BP
  3. Distorted (muffled) heart sounds
24
Q

What are possible DDx for acute pericarditis?

Study These Flashcards
A
  1. PE
  2. MI
  3. Pneumonia
  4. Pneumothorax
  5. Costochondritis
25
What are possible DDx for pericardial effusion?
1. Malignancy 2. Viral pericarditis 3. Latrogenic 4. Idiopathic
26
What are possible DDx for cardiac tamponade
1. Constrictive pericarditis 2. Restrictive cardiomyopathy 3. Cardiogenic shock
27
What investigation is done for chronic pericarditis?
1. CXR 2. ECHO 3. Cardiac CT/MRI
28
What would CXR show in chronic pericarditis?
pericardial calcification
29
What would ECHO show in chronic pericarditis?
increased pericardial thickness – differentiate from restrictive cardiomyopathy
30
What Ix are done for acute pericarditis?
1. ECG 2. Pericardicentesis is suspect cardiac tamponade 3. Echo
31
What does ECG show in acute pericarditis?
1. concave, saddle shape ST segement elevation | 2. PR depression (V2-V6)
32
What bloods are done in acute pericarditis?
1. FBC: elevated WBC 2. ESR/CRP: for inflammation 3. U+E 4. Cardiac enzymes: troponin may be raised 5. LFTs: tamponade means congestion
33
What Ix is done for pericardial effusion?
1. CXR 2. ECG 3. ECHO
34
What would CXR show in pericardial effusion?
enlarged, globular heart if effusion >300mL
35
What would ECG show in pericardial effusion?
low voltage QRS complex
36
What is Ix is diagnostric for cardiac tamponade?
echo
37
What would ECG show in cardiac tamponade?
1. Beck’s triad: falling BP, rising JVP, muffled heart sounds 2. ECG: low voltage QRS
38
How do you manage chronic pericarditis?
pericardiectomy can cure not restrictive unless heart transplant
39
How do you treat acute pericarditis?
1. NSAIDs: with gastric protection 1-2 weeks (PPI) 2. Colchicine 500mcg for 3 months to prevent recurrence : unless TB pericarditis 3. Treat cause 4. Steroids/immunosuppressant if not working 5. Exercise restrict
40
How do you manage acute pericardits if purulent (pus)?
IV antibitoics and above and consider pericardicetnesis)
41
How do you manage pericardial effusion?
1. Treat cause 2. Pericardiocentesis can be diagnostic or therapeutic 3. Send pericardial fluid for culture
42
What is the 1st line treatment for stable cardiac tampoande?
NSAID’s + PPIs + obs
43
What is the 1st line treatment for unstable cardiac tampoande?
pericardiocentesis or surgical drainage (consider pericardectomy)
44
What is the process of pericardiocentesis?
1. 45deg to xiphoid process | 2. pericardium is aspirated
45
What are possible complications of acute pericarditis?
- Cardiac tamponade for acute pericarditis 1. Chronic recurrent pericarditis 2. Constrictive pericarditis
46
What are possible complications of cardiac tamponade?
1. Recurrent pericarditis and pericardial effusion 2. Cardiac arrest 3. Organ hypoperfusion Arrythmias

Z Year3 Cardio Conditions (22 decks)

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