CV 5 Pericarditis Flashcards
Main roles of pericardium
- protective barrier from spread of infection
2. maintain heart shape
what vessels can change venous return to heart?
caval vessels within pericardial space
the vessels of the LA are –
extrapericardial
potential space between 2 serous pericardial layers contain 30 cc of fluid + electrolyte + plasma-like proteins
pericardial complex
about 120 cc of additional fluid can accumulate in pericardium without –
increase in pressure
severe fluid accumulation
effusion
severe decrease in cardiac output leads to hypotension
cardiac tamponade
with effusion, the pericardial pressure markedly increases, preventing proper heart filling during diastole
acute pericarditis
chronic persistent inflammation may lead to severe fibrosis, adhesion, and calcification of pericardium
constrictive pericarditis
cardiac tamponade = compression of heart caused by blood or fluid accumulation in the –
pericardial space
most common cause in young adults
idiopathic
sharp or stabbing chest pain
acute pericarditis
for acute, pain may be –
sudden or gradual and may radiate to back, neck, left arm, shoulder
what may aggravate acute pain?
movement and inspiration
relieve acute pain
leans forward while sitting
low-grade intermittent fever, dyspnea, cough, dysphagia
symptoms of acute
most common and important physical finding of acute pericarditis?
pericardial friction rub
friction rub sounds like –
walking on crunchy snow
– due to death of myocardium (rule out heart attack) may be elevated indicating myocarditis
cardiac enzymes
abnormal chest x-ray may show infiltrate with –
viral or mycoplasma infections
abnormal echocardiogram may show – or ventricular dysfunction with myocarditis
cardiac effusion
with inadequate response to initial tx, – to treat acute pericarditis
corticosteroids
non-steroidal immunosuppressants
to correct effusion (remove as little as 30-50 mL may produce dramatic hemodynamic improvement)
pericardiocentesis
surgical stripping of the scarred portio of the pericardium for constrictive pericarditis
pericardiectomy
