Pericardial Disease Flashcards

1
Q

Treatment for chylopericardium

A

Diet with medium chain triglycerides first
Occurs from disruption of thoracic duct periop
If persistent surgery needed

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2
Q

Constrictive pericarditis

A

dilated IVC
Mitral inflow E peak wave fall of >25% on inspiration
Expiratory flow reversal hepatic veins
Ventricular interdependence
RV pressure increases, LV pressure decreases during inspiration

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3
Q

Pericarditis recurrence

A

Induced by steriod therapy

Colchicine REDUCES pericarditis recurrence

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4
Q

Pulsus Paradoxus

A

> 10mm drop in SBP with inspiration

can also occur with COPD, PTX, OSA (all cause swings in intrathoracic pressure)

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5
Q

Cardiac tamponade hemodynamics

A

JVP
Kusmal’s sign - inspiratory increase in JVP
Loss of Y descent on RA tracing
Pulsus Paradoxus

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6
Q

SLE

A

pericarditis
Diffuse ST elev (concave up)
PR depression except AVR (PR elev and ST dep)
check TTE

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7
Q

Cardiac Tamponade by Echo

A
>30% Mitral flow variation
>60% Tricuspid flow variation
IVC diliations (inc'd central venous pressure
Right heart diastolic collapse
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8
Q

Tamponade

A

ECG
low votage
Electrical alternans

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9
Q

Tamponade

A
tachycardia
Jugular distension
PEA arrest
Pulsus paradoxus >10 with inspiration
loss of y-descent (no filling of RV)
ventricular interdependence (dec SV with inspiration -> inc'd flow into RV -> septum bulges into LV)
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10
Q

Constrictive pericarditis

A

impaired filling pressures, reduced ventricular fxn
inc’d pericardial thickness not required
fatigue, edema, +kusmal, JVD, abdomenal swelling
RHF
Risk factors - CT based surgery, mantle radiation, recurrent percarditis

Mantle radiation can cause ostial CAD and valvular dz

Sx pericardial effusion/tamponade would have pulsus paradoxus

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11
Q

Acute pericarditis

A

ibuprofen 1-2 wks

colchicine 8-12 wks

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12
Q

Myxedema pericardial effusion

A

high triglyceride

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13
Q

Tuberculosis pericardial effusion

A

Adenosine deaminase >40, elevated protein, elevated LDH

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14
Q

Pericardiocentesis

A

if unsure of where needle is - transduce needle…

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15
Q

Etiology of pericardial effusion

A
pericarditis
myxedema (thyroid)
Dresslers
Radiation
uremia
malignancy
infections (TB)
autoimmune conditions
medications (hydralazine)
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