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Flashcards in Pericarditis Deck (23)
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1

What is acute pericarditis.

Inflammation of the pericardium.

2

What are the causes of acute pericarditis. (10)

Viral (EBV, HVI, varicella).
Post-MI.
Dressler's syndrome.
Ureamia.
Tuberculosis.
Rheumatic fever.
Fungal.
Rheumatoid arthritis.
Connective tissue disorders (sarcoidosis).
Malignancy.

3

What are the symptoms of acute pericarditis. (4)

Substernal sharp chest pain.
Worse on inspiration and on movement.
Relieved by sitting forward.
Worse on lying flat.

4

What are the clinical signs of acute pericarditis. (3)

Pericardial friction rub.
May be evidence of a pericardial effusion or cardiac tamponade.
Fever.

5

What is seen on an ECG in a patient with acute pericarditis. (2)

Widespread ST elevation (saddle shaped shape).
Followed by T wave inversion.

6

What investigation should you do in a patient if you suspect a pleural effusion (in acute pericarditis).

Echo.

7

What is a pericardial effusion.

Accumulation of fluid in the pericardial sac.

8

What are the cases of a pericardial effusion.

Any cause of pericarditis.

9

What are the clinical features of a pericardial effusion. (4)

Dyspnoea.
Raised JVP (with prominent x descent).
Bronchial breathing at left base (Ewart's sign).
Look for signs of cardiac tamponade.

10

What is Ewart's sign.

Large effusion compressing left lower lobe.

11

What is seen on CXR in a patient with pericardial effusion.

CXR shows an enlarged globular heart.

12

What is seen on an ECG of a patient with a pericardial effusion. (2)

Low voltage QRS complexes.
Alternating QRS morphologies (electrical alternans).

13

What is constrictive pericarditis.

Te heart is encased in a rigid pericardium.

14

What are the causes of constrictive pericarditis. (3)

Often unknown (in the UK).
TB.
After any pericardial disease.

15

What are the clinical features of constrictive pericarditis. (9)

Right heart failure signs:
Raised JVP (with prominent x and y descents).
Kussmaul' sign.
Soft diffuse apex beat.
Quite heart sounds.
S3.
Diastolic pericardial knock.
Hepatosplenomegaly.
Ascites.
Oedema.

16

What is Kussmaul's sign.

JVP rising paradoxically with inspiration.

17

What is seen on CXR in a patient with constrictive pericarditis. (2)

Small heart.
Pericardial calcification.

18

What is cardiac tamponade.

Accumulation of pericardial fluid raises the intrapericardial pressure, hence poor ventricular filling and a fall in cardiac output.

19

What are the causes of cardiac tamponade. (6)

Any pericarditis.
Aortic dissection.
Haemodialysis.
Warfarin.
Trans-septal puncture at cardiac catheterization.
Post cardiac biopsy.

20

What are the signs of cardiac tamponade. (6)

Raised pulse.
Low BP.
Pulsus paradoxus.
Raised JVP.
Kussmaul's sign.
Muffled S1 and S2.

21

What is Beck's triad. (3)

A way of diagnosis cardiac tamponade:
Falling bP.
Rising JVP.
Muffled heart sounds.

22

What is seen on CXR in a patient with cardiac tamponade.

Big globular fluid.

23

What is seen on the ECG of a patient with cardiac tamponade. (2)

Low voltage QRS.
Electrical alternans.