Pericardial Disease Flashcards
Sudden or gradual onset of sharp or stabbing pain in the chest with radiation to back, neck, L shoulder or arm. Pain more severe with lying supine, relieved with sitting or leaning forward and worse with inspiration. May have friction rub
acute pericarditis
What is the most common cause of pericarditis?
viral or idiopathic
Is a CXR helpful for diagnosing pericarditis?
helpful for ruling out other disease like PE, pleurisy, pneumonia
How is the diagnosis of acute pericarditis made?
audible pericardial friction rub or CP with GLOBAL ST elevation and PR depression
What are complications of pericarditis?
effusion, tamponade, and constriction
over 2/3 of patients with constrictive pericarditis will present with symptoms of what condition?
heart failure
What is the gold standard intervention for constrictive pericarditis?
right or left heart cath
How do constrictive versus restrictive pericarditis differ?
treatment is different…surgery (pericardectomy) for constrictive pericarditis
“Square root” signs in the RV and LV diastolic pressure tracings
constrictive pericarditis
Increased venous return cannot be accommodated in RV because of high EDP. So JVP rises on inspiration. Reliable test for constrictive pericarditis
Kussmaul’s Sign
What determines the physiologic significance of pericardial effusions?
rate of accumulation and compliance of the pericardium
Increased pressure restricts venous return and filling. SV and pulse pressure decrease. HR and venous pressure rise
cardiac tamponade
abnormally large decrease >10mmHg in systolic blood pressure and pulse wave amplitude duringinspiration
pulsus paradoxus
What makes up the components of Beck’s Triad which is associated with cardiac tamponade?
Decreased arterial BP, Increased JVP, Quiet heart sounds
