Pericardial Disease

Question 1

Pericarditis:
treatment
interactions

Answer 1

colchicine 0.6 bid x 1 day then 0.6/d for 6-8 wks
with nsaid (+ppi) or asa
renal, hepatic- bone marrow suppression
steroid if not responsive, but increased recurrence with steroids

Question 2

pericardectomy syndrome

Answer 2

nsaid/colchicine

Question 3

pulsus paradoxus

Answer 3

inspiratory drop >10 mmHg
false + with copd, pul embolism, constrict
false- with ai, hypertrophy, asd, localized effusion, severe hypotension

Question 4

tampanode echo

Answer 4

inflow velocities

Question 5

Constriction phys findings

Answer 5

kussmauls: absent fall in jvp with inspiration
friedricks: prom y descent
echo: dias septal bounce, vent interdependence (may need fluid load)
pa pressures typically higher with restriction

Question 6

Adenosine deaminase

Answer 6

Tb pericarditis

High levels associated with constriction

Question 7

Constriction vs restriction hemo formulae

Answer 7

Constriction RV < 50 LVEDP-RVEDP 0.3

Restriction
RVSP>50, LVEDP -RVEDP >5, RVEDP/RVSP > 0.3

Question 8

Kussmauls in tampanode

Answer 8

Not seen unless constriction- RV can usually accommodate