Pericardial Disease Flashcards
What are the functions of the pericardium?
1.
2.
3.
4.
What is pericarditis?
Inflammation of the pericardial layers
Symptoms:
- Characterized by sharp, pleuritic chest discomfort
- Pain clasically improved with sitting up
Physical exam:
- Friction rub
What can cause pericarditis?
- Idiopathic
- Post-viral
- PostMI(Dressler’s)/cardiacinjury
- Autoimmunedisease
- Uremia
- Radiation
- Drugs
- Malignancy
What do we find on ECG with pericarditis?
Diffuse ST elevation
Concave upwards PR depression
What are the possible complications of pericarditis?
- Pericardial tamponade (from effusion)
- Pericardial constriction
- Recurrences
Treatment of pericarditis?
Analgesia:
High-dose ASA, NSAIDs, colchicine
What is a pericardial effusion?
An abnormal accumulation of pericardial fluid
May result from many etiologies:
- Idiopathic
- Post-viral
- PostMI(Dressler’s)/cardiacinjury
- Autoimmunedisease
- Uremia
- Radiation
- Drugs
- Malignancy
What are the symptoms of pericardial effusion?
Symptoms of Pericardial Effusion:
None
Dyspnea
± Chest pain
Edema
What are the PE findings of pericardial effusion?
None
Tachycardia
Low BP
Elevated JVP
Quiet (muffled) heart sounds
Pulsus paradoxus
Low BP, elevated JVP, and muffled heart sounds are Beck’s Triad
How do we diagnose pericardial effusion?
Echocardiogram, CT/MRI, CXR
PHYSICAL EXAM is very important
It is a CLINICAL diagnosis
What is shown in this CT?
Large pericardial effusion
What is pericardial tamponade?
Pericardial effusion that has accumulater under pressure, and is limiting cardiac chamber filling by compressing underlying chambers
Low output, hypotension, tachycardia, JVP distention, life threatening
Pulsus paradoxus
What is pulsus paradoxus?
Drop in blood pressure on inspiration of more than 10 mmHg
What are the ECG findings of tamponade?
Low voltage
Sinus tachycardia
Electrical alternans
Treatment of cardiac tamponade?
Drainage: pericardiocentesis or surgery
Fluid sent for investigation (yields diagnosis 30% of time)
