Brainscape's Knowledge GenomeTM

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


See full index

CV <3 > Lecture 7 Part 2: Pericardial Disease > Flashcards

Lecture 7 Part 2: Pericardial Disease Flashcards

1
Q

What are the functions of the pericardium?

A
  • Prevents overdilation of the heart chambers.
  • Prevents the heart from shifting in the chest.
  • Prevents lung infections from infecting the heart.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the primary etiologies of pericarditis?

A
  • Idiopathic
  • Infectious (Viral MC)
  • Systemic diseases (hypothyroidism, inflammatory, CKD)
  • Neoplasms
  • Drug-induced
  • Pericardial injury
  • Myocardial injury

Viral is seasonal as well.
All the inflammatory causes are generally autoimmune diseases.

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

If a bacterial etiology is suspected for pericarditis, what most likely precipitated it?

A

Lung infection

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

What two cancers are most likely to cause pericarditis with a cancerous etiology?

A
  • Lung
  • Breast

These two make up about 50% of cancerous pericarditis cases.

Overall, cancers cause about 10% of pericarditis cases.

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

What drugs are likely to induce pericarditis?

A
  • Amoxicillin or cromolyn (Allergy)
  • Anthracycline chemo agents (direct cardiac toxicity)
  • Procainamide, hydralazine, methyldopa, isoniazid (Drug-induced SLE)
  • Phenytoin and minoxidil (unknown)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Dressler syndrome?

A

A syndrome that appears 2 weeks after an MI, resulting in pericarditis/inflammatory response.

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

What are the 4 primary diagnostic features of pericarditis?

A
  1. Chest pain
  2. Pericardial friction rub
  3. EKG changes
  4. Pericardial effusion

2 out of 4 is diagnostic.

EKG changes: Widespread, diffuse STE or PR depression as prof rice taught us!
Can lead to T wave inversion if caught later.
CPEP

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

What is the mnemonic for pericarditis causes?

A
  • Collagen vascular changes
  • Aortic aneurysm
  • Radiation
  • Drugs (hydralazine)
  • Infections
  • Acute renal failure
  • Cardiac infarction
  • Rheumatic fever
  • Injury
  • Neoplasms
  • Dressler’s Syndrome

CARDIAC RIND

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the CARDINAL symptom of pericarditis?

A

Chest pain

Usually relieved by leaning forward or sitting up.

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

How does someone with pericarditis typically present?

A
  • Dyspnea
  • Fever
  • Pericardial friction rub
  • Angina that is relieved by leaning forward
  • Sharp, retrosternal pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the first-line pharmacological tx for pericarditis pain and inflammation?

A
  • NSAIDs: Ibuprofen or indomethacin
  • ASA should be used post-MI only.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What conditions should make us consider inpatient managment for pericarditis?

A
  • Fever > 38.3C
  • Subacute onset
  • Immunosuppression
  • Trauma
  • Oral AC therapy
  • ASA/NSAID failure
  • Myopericarditis
  • Large pericardial effusion or tamponade
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the pharmacological therapy for preventing pericarditis recurrence?

A
  • Colchicine
  • Corticosteroids (for severe or auto-immune etiology)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What happens when a pericardial effusion gets really big?

A

Cardiac tamponade

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

What is Beck’s triad?

A
  1. Distant/muffled heart sounds
  2. JVD or increased JVP
  3. Hypotension

NOT PATHOGNOMONIC for cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What signs are seen in cardiac tamponade?

A
  1. Kussmaul’s sign: increased JVP on inspiration (Normally should decrease)
  2. Pulsus paradoxus (BIG inspiratory fall in arterial pressure during systole)
17
Q

What EKG finding is pathognomonic of cardiac tamponade?

A

Electrical alternans

QRS complex has varying amplitude on each beat.

18
Q

What sign on a CXR suggests a large pericardial effusion?

A

Water bottle heart

19
Q

What is the initial choice of test for detecting pericardial effusions?

A

TTE

20
Q

When we get a TTE, what 3 things are we looking for in pericarditis?

A
  • RV collapse
  • LV collapse
  • Dilated IVC w/o inspiratory collapse
21
Q

What would prompt us to admit someone to the hospital for pericardial effusions?

A
  1. Large effusions
  2. Fever + leukocytosis
  3. Immunosuppressed
  4. Hx of Vit-K antagonists
  5. Acute trauma
  6. Failure to respond to 7 days of NSAIDs
  7. Elevated trop, which suggests myopericarditis
22
Q

If pericardial fluid returns a thin to creamy pus, what are the most likely etiologies?

A

Purulent or suppurative.

22
Q

What is the primary procedure treating for pericardial effusions?

A

Pericardiocentesis

23
Q

If pericardial fluid returns high protein and cholesterol, what is the probably underlying etiology?

A

Hypothyroidism.

24
Q

What findings might suggest uremic pericarditis?

A

Adhesions

25
Q

When is pericardial diodesis used?

A

Recurrent pericardial effusions

26
Q

When is pericardiotomy indicated?

A

Large, recurrent effusions or ones that don’t resolve.

27
Q

What is a pericardial window?

A

Makes a window from pericardial space to the pleural space.

28
Q

When is pericardiectomy indicated?

A

Large effusions in which a pericardiotomy cannot be performed or was unsuccessful.

29
Q

What is constrictive pericarditis and what is the primary pathophysiology it results in?

A
  • Thickened, fibrotic, adherent serous pericardium
  • Right sided HF due to poor preload.
30
Q

What is the MCC of constrictive pericarditis in developing countries? Developed?

A
  • Developing: TB
  • Developed: Radiation, surgery, viral
31
Q

How does constrictive pericarditis usually present?

A
  • Progressive dyspnea, fatigue, and weakness
  • RHF symptoms
  • Kussmaul sign
  • Afib is common
32
Q

What test is generally confirmatory for constrictive pericarditis?

A

Cardiac catheterization.

33
Q

What is the primary drug class we use to improve symptoms in constrictive pericarditis?

A

Diuretics

34
Q

When is surgical pericardiectomy recommend?

A

Unresponsive to diuretics

CV <3 (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions