Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Foundations II (Cholley) > Diseases of pericardium > Flashcards

Diseases of pericardium Flashcards

1
Q

What do pericardial diseases cause?

A
  • Increased pericardial fluid

- Inflammatory disease, effusive disease, or BOTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The pericardium contains how much plasma ultrafiltrate?

A

15-50mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common disorder of the pericardium?

A

Acute pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acute pericarditis is found in how many hospitalized pts?

A

.1-.2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute pericarditis is found in how many pts in the ED w/ non-ischemic chest pain?

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes acute pericarditis?

A

Idiopathic

- Undx viral infections: Coxsackie virus B, Influenza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does acute pericarditis present?

A

As an isolated processes or 1st sign of underlying systemic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the presenting sx in acute pericarditis?

A

Chest pain (in > 95%)

  • Sudden onset
  • Sharp, pleuritic
  • Radiation to trapezius ridge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What improves & exacerbates chest pain?

A
  • Improves w/ leaning forward

- Exacerbated by coughing, inspiration, lying flat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is seen on PE for acute pericarditis?

A

Pericardial friction rub

  • Scratchy, squeaky quality
  • Loudest over LSB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What causes pericardial friction rub?

A

Friction btwn the 2 layers of pericardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does acute pericarditis look like on ECG?

A
  • Changes correlate w/ epicardial inflammation
  • *Diffuse ST elevation (concave up)
  • PR segment depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Stages of acute pericarditis

A
  • Stage 1: diffuse ST elevation w/ PR depression
  • Stage 2: normalization of ST & PR segments
  • Stage 3: diffuse, T wave inversion
  • Stage 4: normalization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pericardiocentesis & pericardial biopsy

A
  • Low yield

- Can be dx & therapeutic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When might you perform a pericardiocentesis?

A
  • Refractory to med therapy
  • Hemodynamic compromise
  • High complication rates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When might you perform a pericardial biopsy?

A
  • Illness lasting > 3 wks w/out a definitive dx

- Recurrent pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the procedure of pericardiocentesis

A
  • Supine w/ head of bed at 30-60 degree
  • Under u/s guidance
  • Insert needle at 5-6th ICS at LSB
18
Q

What are markers of acute pericarditis?

A
  • Cardiac: Elevated troponin

- Inflammatory: CRP, ESR, WBC

19
Q

Dx criteria for acute pericarditis

A

Need 2 of the following:

  1. Typical CP
  2. Pericardial friction rub
  3. Characteristic ECG changes
  4. New/worsening pericardial effusion
20
Q

What are the 3 overall goals of tx for acute pericarditis?

A
  1. Relief of pain
  2. Resolve inflammation
  3. Prevent reoccurrence
21
Q

How long is tx for acute pericarditis?

A

2 wks or less, unless sx persist

22
Q

When is pericardial effusion present?

A

When amt of fluid inside pericardium exceeds normal amt

23
Q

What causes pericardial effusion?

A

Secondary to injury or insult to pericardium

  • Idiopathic
  • Infectious
  • Malignancy
  • Autoimmune
  • Drugs
24
Q

Pericardial effusion sx

A
  • Asx (often discovered incidentally)

- CP, pressure, discomfort

25
Q

Pulsus Paradoxus

A

Decrease in SBP > 10 w/ inspiration, signaling that CO is falling during inspiration

  • May present w/ pericardial effusion
  • Not specific to pericardial diseases
26
Q

When is pericardial effusion considered chronic?

A

3 months or more

27
Q

When is pericardiectomy performed?

A

If reaccumulation of fluid occurs despite repeat pericardiocentesis

28
Q

Define: Hemorrhagic pericardial effusion

A

Blood fills in pericardial space

29
Q

What is the main cause of hemorrhagic pericardial effusion?

A

Malignancy (26%)

30
Q

What can pericardial effusion lead do?

A

Cardiac tamponade

31
Q

Define: Cardiac tamponade

A

Compression of all cardiac chambers due to increased pericardial pressure

32
Q

Features of cardiac tamponade

A
  • Chambers become smaller, diastolic compliance reduced
  • Venous return to R. heart increases w/ inspiration
    ˚LV filling falls –> CO & BP fall
33
Q

When does cardiac tamponade become subacute?

A

Days to weeks

34
Q

What is regional cardiac tamponade?

A

Localized hematoma, only selective chambers become compressed
- Post-pericardiotomy or post MI

35
Q

Cardiac tamponade: Beck’s Triad

A

Hypotension
JVD
Muffled heart sounds

36
Q

Constrictive pericarditis

A

Scarring & loss of normal elasticity of pericardial sac

  • Typically chronic
  • Restricts filling volume –> SV & CO become reduced
37
Q

What is the most common presentation of constrictive pericarditis?

A

Sx of HF

38
Q

What is a sensitive PE finding for constrictive pericarditis?

A

JVP (93%)

39
Q

What is JVP a reflection of?

A

Central venous pressure (CVP)

40
Q

What is specific for constrictive pericarditis on CXR?

A

Pericardial calcification

41
Q

What is the only definitive tx for constrictive pericarditis?

A

Pericardiectomy

Foundations II (Cholley) (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions