PE Flashcards
What are the layers of the heart from outer to inner?
- Fibrous pericardium
- Serous parietal pericardium
- Pericardial space
- Visceral pericardium (epicardium)
What is heart layer that is the smooth wall of a cavity called?
Serous parietal layer
What is the heart layer that is smooth toward the Organ called?
Visceral layer (epicardium)
What is the heart layer that is the thick outer sack called?
Fibrous pericardium
What is another name for the visceral layer of the heart?
Epicardium
List the layers of the heart from inner to outer
- Visceral pericardium (epicardium)
- Pericardial space
- Serous parietal pericardium
- Fibrous pericardium
The epicardial layer of the heart is also known as?
Visceral layer
What are some ideologies of a pericardial effusion?
-idiopathic
-infection
-TB
-Uremia
-autoimmune/inflammatory diseases
-Neoplastic disease ( abnormal tissue)
-MI
-Post cardiac surgery
-Trauma
-Radiation
What is neoplastic disease?
Abnormal tissue
What is the pathophysiology of a pericardial effusion?
1-pericarditis occurs
2. Extra fluid secretes into the pericardial space
3. heart try’s to expand to compensate for extra fluid
What are some physical signs of a pericardial effusion?
-positional angina
-Dyspena
-Distended neck veins
- friction rub murmur
-pulses paradoxus
What is the murmur associated with a pericardial effusion?
Friction rub
What is the pulses paradoxes change for PE?
A decrease of <10mmhg of the systolic BP with inspiration
What is the biggest echo sign of a PE?
Echo free space between the visceral and parietal pericardium
With a PE always perform a ____ valve to ____ sweep in m-mode.
Aortic to LV
Isolated interior echo free spaces are indicative of?
Most likely a epicardial (visceral) fat pad not an effusion
True or false- Loculated effusions are common
False they’re rare
Loculated effusions are ___ except in what 2 cases?
Rare ; post cardiac surgery and metastatic disease
What is commonly seen in long-standing effusion or effusion from metastatic disease?
Fibrin strands
With PE what should you do with your Doppler?
Check for respiratory variation in flow across all valves
A respiratory variation of _____ indicates possible ____
> 25% ; tamponade
In what cardiac cycle do you measure a PE?
End diastole
What is the measurement of a small pericardial effusion?
<1cm posteriorly
What is the measurement of a medium sized pericardial effusion?
1-2cm anterior and posterior
What is the measurement for a large pericardial effusion?
> 2cm surrounding the heart
Pericardial effusion may be seen _____ to the left atrium in the____sinus
Posterior ; and oblique
Where is the oblique sinus?
Posterior to the left atrium between two sets of pulmonary veins
A pericardial effusion can often be seen in patients with?
- Aortic stenosis
- Atrial flutter
- Myocardial infarction
- Renal failure
- Renal failure
What is the pericardial effusion grading criteria for small medium and large?
Small PE = <1cm
Moderate PE= 1-2cm
Severe PE= >2cm
