Pericardial disease

Question 1

What is the most common cause of constrictive pericarditis in the developing world?

Answer 1

Tuberculosis

Question 2

What is the likely diagnosis in a patient with dyspnea, peripheral edema, ascites, JVD without inspiratory decline, and pericardial calcifications on CXR?

Answer 2

Constrictive pericarditis

Question 3

What is the likely diagnosis in a post-MI patient that presents a few weeks later with chest pain that improves while leaning forward and diffuse ST elevation on ECG?

Answer 3

Dressler syndrome

Question 4

One ECG change associated with cardiac tamponade is ___, which occurs due to “swinging” movement of the heart in a large effusio

Answer 4

electrical alternans

Question 5

What imaging study is used for the definitive diagnosis of pericardial effusion / cardiac tamponade?

Answer 5

Echocardiography

Question 6

Cardiac tamponade/Constrictive pericarditis results in ____sided heart failure

Answer 6

right

Question 7

What is the likely diagnosis in a patient that presents with distant heart sounds, JVD, and hypotension with cardiomegaly on X-ray one week after having cardiac surgery?

Answer 7

Postpericardiotomy syndrome( typically manifests 1–6 weeks after cardiothoracic surgery as a result of an autoimmune inflammatory process in the pericardium)

Question 8

Aortic dissection may result in ____ as a result of backflow into the pericardium

Answer 8

cardiac tamponade

Question 9

What is the likely diagnosis in a patient with previous Hodgkin lymphoma status-post chemoradiation therapy that presents with dyspnea, JVD, ascites, and hepatomegaly?

Answer 9

Constrictive pericarditis

Question 10

What is the most common cause of acute pericarditis?

Answer 10

Idiopathic (presumed viral)

Question 11

What is the likely diagnosis in a patient on several medications with swelling and tenderness of the hand and knee joints and acute pericarditis?

Answer 11

Drug-induced lupus

Question 12

The diagnosis of acute pericarditis requires at least two of the following four criteria:

Answer 12

• Characteristic chest pain (pleuritic)
• Pericardial friction rub
• Typical ECG changes (diffuse, concave, upward-sloping ST segment elevations)
• New or worsening pericardial effusion on echocardiography

Question 13

What is the treatment for acute pericarditis?

Answer 13

NSAIDs and colchicine

Question 14

Acute pericarditis commonly presents with sharp chest pain that is aggravated by ______ and relieved by sitting up and leaning ____

Answer 14

inspiration
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