Malozzi- Pericardium Flashcards by Madeline Wing

2 layers of pericardium

parietal and visceral

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is pericardium essential for life

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causes of this include:
viral
bacterial
fungal
autoimmune
tumor metastasis
metabolic
trauma

pericarditis

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inflammatory syndrome of pericardium w/ or w/out effusion and infectious or non-infectious causes

acute pericarditis

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most common cause of pericarditis

from viral infection (Coxsackie B)

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signs of this include:
fever
sob
chest pain worse when lying down
friction rub

acute pericarditis

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happy ST

pericarditis

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sad ST

STEMI

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what will you see in labs drawn for acute pericarditis

elevated WBC’s, ESR, CRP, troponin I

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effusion seen in echo

pericarditis

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CXR for pericarditis

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Rx acute pericarditis

aspirin and NSAIDs; then corticosteroids

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what happens if patient doesn’t complete Rx for acute pericarditis

recurrent pericarditis

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to Rx recurrent pericarditis

aspirin and NSAIDs first; then corticosteroids

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this is thought to be immune mediated

recurrent pericarditis

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can be caused by coxsackie B, herpes, and adenovirus

infectious pericarditis

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most common type of infectious pericarditis in developing countries

tuberculous

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to Dx tuberculous pericarditis

acid fast bacilli (stain)

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2 phases of tuberculous pericarditis seen in 30% of patients

effusive and constrictive

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this phase is due to fluid accumulation

effusive

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this phase is due to calcified lesion accumulation

constrictive

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to Rx tuberculous pericarditis

rifampicin and isoniazid and others for up to 6 months

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2 main causes of bacterial pericarditis

staph and strep

what can present with bacterial pericarditis

cardiac tamponade

pericarditis or effusion related to metastatic spread of cancer

malignant pericarditis

to Dx malignant pericarditis

fluid analysis (cytology and tumor markers)

main autoimmune diseases that can cause pericarditis

SLE sarcoidosis RA

trauma and surgery can cause what

pericarditis

post MI pericarditis aka

Dressler Syndrome

Rx Dressler syndrome

Aspirin

more exposure to ______ can cause pericarditis

radiation

pericardial effusion

this can be incidental or emergent (cardiac tamponade)

pericardial effusion

2 main ways fluid accumulates in pericardial effusion

exudative transudative

fluid build up due to inflammation of pericardium layers

exudative fluid

fluid build up due to impaired lymphatic drainage

transudative fluid

pericardium can stretch to a certain degree; what happens when it is maxed out

will put pressure on heart chambers

patient presents as hypotensive and tachycardic (compensatory)

rapid pericardial effusion

patient presents w/ diminished heart sounds, JVD, low voltage on EKG

slow pericardial effusion

this is represented by impaired ventricular diastolic filling

increased jugular venous pressure

electrical alternans seen in pericardial effusion

a drop of >10 mmHg SBP during inspiration

pulses paradoxus in pericardial effusion due to ventricular interdependence

this is due to RV filling and pushing interventricular septum against L heart

pulsus paradoxus

to Rx cardiac tamponade/pericardial effusion

pericardiocentesis pericardial window

due to ongoing inflammation resulting in fibrosis of pericardial sac

constrictive pericarditis

most common cause in developed world of contrictive pericarditis

radiation prior cardiac surgery

presents with: exertional dyspnea abd distention edema JVD Kussmaul's sign

constrictive pericarditis

paradoxical increase in JVP with inspiration (seen under mandible)

Kussmaul's sign

constrictive pericarditis

Decreased compliance (stiffness of pericardium) Increase filling pressures Decreased SV and CO Ventricular interdependence (pressed against LV)

due to fibrosis of pericardium

shows discordance; LVP decreases and RVP increases

constrictive pericarditis

doesn't have ventricular interdependence b/c muscle problem; shows concordance (LVP and RVP move in same pattern)

restrictive cardiomyopathy

to Rx constrictive pericarditis

pericardiectomy pericardial window

Kussmaul's sign seen in what

constrictive pericarditis

pulsus paradoxus seen in what

pericardial effusion/ cardiac tamponade