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2- SA- Cardiology > Pericardial disease > Flashcards

Pericardial disease Flashcards

1
Q

What is the pericardium

A

membrane surrounding the heart

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2
Q

List the function of the pericardium

A

Not essential
prevents distension of the heart in the chest
reduces friction
equalises gravity
prevention of overdilation
regulation between stroke volumes

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3
Q

What is cardiac tamponade

A

acute compression of the heart caused by fluid accumulation in the pericardial cavity

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4
Q

What can chronic tamponade of the heart lead to

A

right congestive heart failure

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5
Q

what can acute tamponade of the heart lead to

A

a quick drop in blood pressure

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6
Q

Why do you occasionally get GI signs with pericardial effusion

A

the vascular bed becomes congested and the GIT isn’t perfused efficiently

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7
Q

List 9 clinical signs associated with pericardial effusion

A

Jugular distension
positive hepatojugular reflex
ascites
tachycardia
muffled heart sounds
weak femoral pulses
pale MM
tachypnoea
GIT signs

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8
Q

Describe the hepatojugular reflex

A

as you palpate cranial abdomen someone looks at jugular- will see wave up jugular- shows you have high RA pressure

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9
Q

How do you diagnose pericardial effusion

A

clinical signs
echo
ECG

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10
Q

what usually comes first in dogs- RCHF or pericardial effusion

A

pericardial effusion

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11
Q

what usually comes first in cats- CHF or pericardial effusion

A

CHF

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12
Q

How can we tell if the pericardial effusion of the CHF was first

A

if pericardial effusion was first, the right atrium will be collapsed

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13
Q

what is a classic sign of pericardial effusion on ECG

A

electrical alternans

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14
Q

what are electrical alternans

A

complexes are bigger then smaller on repeat

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15
Q

How do we see pericardial effusion on radiogrpahy

A

globoid cardiac silhouette with a sharp outline

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16
Q

Describe how you treat a pericardial effusion

A

oxygen
IV fluids
pericardiocentesis

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17
Q

when do we generally have to do a pericardial strip

A

if you have to repeat pericardiocentesis more than 3 times

18
Q

why do we generally drain pericardial effusion from the right

A

avoids laceration of the main coronary vessels

19
Q

List 5 possible complications of a pericardiocentesis

A

cardiac puncture
arrythmias
dissemination of infection or neoplasia
atrial fibrillation
myocardial stunning

20
Q

how can you check if the blood you are draining during pericardiocentesis is from the pericardium or from the heart

A

blood from the ventricles will clot, blood from the pericardium will not

21
Q

Why is there a risk of arrythmias post pericardiocentesis

A

because of the rapid filling and dilation of the RA and RV

22
Q

What is myocardial stunning

A

temporary loss of contractile function that persists for hours to days after perfusion has been restored

23
Q

list the 4 most common causes of pericardial effusion in dogs

A

cardiac neoplasia
idiopathic
left atrial rupture
coagulopathies, uremic, infection

24
Q

List 4 common cardiac tumours

A

haemangiosarcomas
heart base tumours (chemodectoma)
mesotheliomas
lymophsarcoma

25
Q

what is a chemodectoma

A

tumour of the chemical sensing cells in the aortic arch

26
Q

what is a haemangiosarcoma

A

malignant tumour of vascular endothelium

27
Q

describe heart base tumours

A

chemodectomas and ectopic thyroid carcinomas

28
Q

describe mesotheliomas

A

cancers of the mesothelial cells

29
Q

where do haemangiosarcomas commonly form within the heart

A

on the wall of the right atrium

30
Q

where do chemodectomas commonly form

A

round the aortic arch

31
Q

what is a left atrial rupture usually secondary to

A

chronic degenerative valve disease

32
Q

why should we not do a pericardiocentesis if we suspect a LA tear

A

we may dislodge the clot

33
Q

describe a peritoneal pericardial diaphragmatic hernia

A

communication between the pericardial and peritoneal cavities

34
Q

what is a pericardial cyst

A

most common benign tumour of the pericardium

35
Q

what causes constrictive pericardial disease

A

repeated pericardial draining

36
Q

Describe how to treat constrictive pericardial disease

A

pericardectomy

37
Q

can you see constrictive pericardium on ultrasound

A

yes- it will show as a bright white pericardium stuck to the heart wall

38
Q

where do we make our incision for a pericardiocentesis

A

at the 5th intercostal space on the RHS

39
Q

why does a large atria show on ECG as inverted QRS

A

if the right side is producing more power than the left side, then the QRS complexes will be inverted

40
Q

List 3 indications for a pericardectomy

A

severe chronic pericardial disease
restrictive pericardial disease
Palliative surgery for neoplastic aetiologies of pericardial effusion

2- SA- Cardiology (15 decks)

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