Diseases of Pericardium *

Question 1

What’s the visceral pericardium?

Answer 1

It’s the inner serosal layer which adheres to the other wall of the heart. It’s composed of a signal layer of mesothelial cells.

Question 2

What’s the parietal pericardium?

Answer 2

It’s the fibrous outer layer that’s formed by backward reflected visceral layer.

Question 3

What are the functions of the pericardium?

Answer 3

It fixes the heart within the mediastinum to limit motion, it prevents extreme dilation of the heart, it prevents spreading of infection from the adjacent lungs and it reduces friction.

Question 4

What’s acute pericarditis?

Answer 4

It’s the inflammation of the layers of pericardium. It’s most common pericardium disease!

Viral infections, TB, uraemia, connective tissue diseases, drug-induced

Question 5

What are infectious causes of acute pericarditis?

Answer 5

Causes are unknown. Viral infections such as influenza and Hep B though. Also in patients with cardiovascular disease and AIDS.

Question 6

What’s tuberculosis pericarditis?

Answer 6

Occurs in immunosuppressed patients. Reactivation of organism in mediastinal lymph node which spreads into pericardium.

Question 7

What’s bacterial pericarditis?

Answer 7

Occurs after performating trauma to chest or contamination during surgery or extension of pneumonia.

Question 8

What’s dressler syndrome?

Answer 8

Develops weeks-months after a myocardial infarction. Believed to be autoimmune against antigens released from necrotic myocytes.

Question 9

What’s neoplastic pericarditis?

Answer 9

A Tumour involvement of the pericardium

Question 10

What’s uremic pericarditis?

Answer 10

Serious complication in chronic renal failure.

Question 11

What are the 3 stages of pericarditis?

Answer 11

1) local vasodilation.
2) Increased Vascular permeability
3) Leukocyte exudation

Question 12

What is serous pericarditis?

Answer 12

It’s characterized by scant leukocytes, lymphocytes and histiocytes (an inflammatory mediator)

Question 13

What is serofibrinous Pericarditis?

Answer 13

It’s a pericardial fluid discharge containing plasma proteins. It yields a rough and shaggy shape. It causes thickened or fused visceral and parietal layer.

Question 14

What is suppurative pericarditis?

Answer 14

It’s an intense inflammatory response associated with bacterial infections.

Question 15

What is hemorrhagic pericarditis?

Answer 15

It’s a bloody form of pericardial inflammation caused by tuberculosis or malignancy.

Question 16

What’s pericardial effusion?

Answer 16

It’s a larger volume of fluid accumulating within the pericardial space. It can be caused by any form of pericarditis.

Question 17

Noninflammatory serous effusion may be the result of what?

Answer 17

1. Increased permeability
2. Increased capillary hydrostatic pressure.
3. Decreased plasma oncotic pressure.

Question 18

What is chamber compression (in pericardial effusion)?

Answer 18

It’s when a small change in volume (past the critical point) causes a dramatic increase in pressure.

Question 19

What factors determine whether pericardial effusion remains clinically silent or if cardiac compression occurs?

Answer 19

1. Volume of fluid
2. Rate at which fluid accumulates.
3. Compliance characteristics of the pericardium

Question 20

What is cardiac tamponade?

Answer 20

It’s an accumulation of pericardial fluid under high pressure. Cardiac chambers compress, and there’s severely limited cardiac filling. Stroke volume and cardiac output declines

Question 21

What can cause cardiac tamponade?

Answer 21

Any cause of Acute pericarditis can progress to CT.

Question 22

What causes cardiac compression?

Answer 22

It’s when the diastolic pressure within each chamber increases and equals the pericardial pressure.

Question 23

What causes systemic and pulmonary venous pressure increase?

Answer 23

Altered venous return

Question 24

What causes reduced ventricular filling during diastole?

Answer 24

SV and CO decline and eventually results in inadequate tissue perfusion

Question 25

What is constructive pericarditis?

Answer 25

It’s characterized by a pericardium that’s scarred, thickened and calcified. Long-standing pericardial inflammation can lead to this. Rigid, scarred pericardium prevents normal filling of chambers. There’s also impaired right and left ventricular filling