30. Diseases of pericardium, pericardial effusion - causes, clinical presentation, diagnosis and management (medical and surgical treatment).

Question 1

what is the cause of pericarditis

Answer 1

can be idiopathic

myocardial damage - AMI - dressler syndrome
postoperative - valvular surgery

infections
vrus - cocsackie virus
bactera pnumoccocus , meningo
fungal - candida

tumors - metastitc

connective tissue disease - sale , rheumatoid arthritis

metabolic diseaes - uremia

Question 2

what are the symptoms for pericarditis ?

Answer 2

chest pain
may commence suddenly and constantly increasing - radiation t the back , neck and arms
change with body position - stronger - decubitus position
lessens when bending forward
when swallowing

fever less than 39 degrees

Question 3

what is found on physical examination pericarditis ?

Answer 3

pericardial rubbing
tachycadia
S3 gallop

cardiac tamponade - dysphagia ,hoarseness of voice - affects the laryngeal recurrence

paradocial pulse - disappear during inspiration sandpaper during expiration

cardiogenic shock

pale and cold

Question 4

what is the diagnosis of pericarditis ?

Answer 4

ECG - st elevation , pr depression

stage 1- concave diffusion of st elevation
early stage 2 - st junction near to baseline , pr deviation
late stage 2 - T waves progressively become flat or negative
stge 4 - ECG retruns to the premorbid stage

ultrasound - to see pericardial effusion and adhesions and cohesions of pericardium
define the degree of cardiac tamponade - moderate - 250-500ml
large more than 500ml
decreased ejection fraction

X ray - increased silhouette of the heart

Question 5

what is is the treatment of pericarditis

Answer 5

according to cause ?
antibiotics
drainage of pericardial effusion