Pericarditis Flashcards Preview

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Flashcards in Pericarditis Deck (13):
1

acute pericarditis

idopathic syndrome
self-limited
Sx: sharp substernal pleurotic positional pain, pericardial friction rub
EKG: ST elevation not confined to a coronary territory

2

serous pericarditis

smooth, effusion of serous fluid (low protein)
scant neutrophils, lymphocytes, macrophages
causes: HF, lymphatic obstruction by tumor, hypoalbuminemia

3

fibrinous pericarditis

dry, rough, shaggy
neutrophils, lymphocytes, macrophages
if it has effusion: serofibrinous
causes: viral myopericarditis, uremia (symptomatic high uric acid), acute MI, metastatic malignancy, autoimmune

4

hemorrhagic pericarditis

serous, fibrinous, or purulent plus hemorrhage
can have effusion or exudate
associated with: metastatic carcinoma, leukemia (thrombocytopenia), TB

5

purulent pericarditis

suppurative pericarditis
red, granular surface with pus
LOTS of neutrophils, exudate in pericardium

6

constrictive pericarditis

rare
encasement of heart in dense fibrous or fibrocalcific scar preventing hypertrophy or dilation
cause: previous purulent or TB pericarditis
Tx: surgical stripping

7

pericardial effusion

normal: 15-50ml serous fluid in pericardium
sudden increase: up to 250ml OK, 250-300ml: fatal
slow increase: can tolerate up to 1 liter
causes: viral myopericarditis, metastatic malignancy, autoimmune, drug-induced, renal failure, hemopericardium

8

hemopericardium

bleeding into pericardium

9

cardiac tamponade

syndrome
Sx: jugular venous distension, muffled heart sounds, hypotension, pulsus paradoxus
echo: diastolic collapse of right atrium and ventricle
swap-ganz: equalization of pressures
Tx: pericardiocentesis

10

forms of post-MI pericarditis

1. extension of visceral pericarditis to parietal over large transmural infarct
2. dresseler syndrome (2-12 weeks after infarct): probably autoimmune

11

autoimmune pericarditis

lupus and RA patients (due to polyserositis with simultaneous pleuritic and peritonitis)

12

drug induced pericarditis

procainamide and hydralazine

13

adenocarcinoma

can metastasize to lung
cytology mucin production, large nucleus, big cells