CARDIAC Section 10: Pericardium Flashcards
How many layers does the pericardium have?
Two layers
- Visceral
- Parietal
situation where the fluid volume
exceeds 50cc between the pericardial layers.
Pericardial Effusion
MOST COMMON cause of pericardial effusion?
REnal failure (uremia)
Common causes of pleural eff
Lupus, and Dressier Syndrome (inflammatory effusion post MI).
On CXR they could show this 3 ways:
(1) Normal Heart on Comparison, Now Really Big Heart.
* Classic history of a 30 year old female with an ugly rash on her face (lupus).
* Classic history of a recent MI (Dressier syndrome).
(2) Giant Water Bottle Heart,
(3) Lateral CXR with two lucent lines (epicardial and pericardial fat) and a central opaque line (pericardial fluid) - the so called “oreo cookie sign.”
What sign?
two lucent lines (epicardial and pericardial fat) and a central opaque line (pericardial fluid) - the so called “oreo cookie sign.”
What is cardiac tamponade?
Pericardial effusion can cause elevated pressure in the pericardium and result in compromised filling of the cardiac chambers (atria first, then ventricles).
What is the key factor of cardiac tamponade?
Rate of fluid accumulation (as little as 100cc)
Cardiac tamponade on imageing
short-axis imaging during deep inspiration showing flattening or inversion of the intraventricular septum toward the LV - consequence of augmented RV filling
Another indirect sign of cardiac tamponade
eflux of contrast into the IVC and azygos system.
shown as an ROI measuring water density along the right cardiophrenic sulcus.
Pericardial Cysts:
the most common situation in Congenital/Acqured absence of the pericardium
partial absence of the pericardium over the
eft atrium and adjacent pulmonary artery.
When the left pericardium is absent the heart shifts towards the left or right?
Most risk of strangulation in the abscence of pericadium
Left atrial appendaga
