Darrow - Diseases of the Pericardium Flashcards
In pericarditis, what position makes pt’s pain worse? Better?
Supine makes it worse
Leaning forward makes it better
What is the most common cause of pericarditis?
Viral infection, i.e. from coxsackie
As pericarditis progresses, what other condition can it cause?
Myocarditis
What kind of cardiac involvement can Lyme disease result in?
Heart block
Myopericarditis
What is the treatment for pericarditis?
NSAIDS
Colchicine
IVIG in extreme cases
What is pulsus paradoxus?
>10mmHg drop in systolic blood pressure during inspiration
What are the different waves of jugular venous tracing and what do they represent?
A wave: atrial contraction
X wave: atrial relaxation
V wave: atrial filling
Y wave: atrial emptying
What finding on a jugular venous pressure tracing is a marker for cardiac tamponade?
Slow Y descent, or atrial emptying
Dr. Beck, you PAY for the CT
Beck’s Triad
Pulsus paradoxus
electrical Alterans
slow Y descent
together indicate Cardiac Tamponade
What is constrictive pericarditis?
Calcification of pericardium that constricts heart
What is Kussmaul sign?
In constrictive pericarditis, the jugular vein engorges upon inspiration
What is the characteristic appearance of the JVP tracing associated with constrictive pericarditis?
The Y descent will be much sharper and shorter, not nearly as gradual
What is a pericardial knock?
Like an S3 but much harder
due to rapid early filling in diastole
What are some causes of constrictive pericarditis?
TB
Post radiation
Cardiac surgery
Viruses
Trauma
What can mimic constrictive pericarditis?
Restrictive cardiomyopathies
LV diastolic dysfunction
