Pericardial Disease Flashcards by Thomas Eraifej

Q

Actue pericarditis definition

A

Inflammation of pericardium

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Q

General causes of acute pericarditis

A

Idiopathic

Infection

Dressler’s syndrome

Drugs

Other

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Q

Infective causes of acute pericarditis

A

Viral

Bacterial

Fungi

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Q

Viral causes of acute pericarditis

A

Coxsackie virus

EBV

VZV

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Q

Bacterial causes of acute pericarditis

A

Pneumonia

Rheumatic fever

TB

Staphs, Streps

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Q

Dressler’s syndrome definition

A

Form of pericarditits

2 to 10 wks post MI / myocardial injury

Auto-antibodies form against heart muscle

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Q

Drug causes of acute pericarditis

A

Hydralazine

Penicillin

Isoniazid

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Q

Other random causes of acute pericarditis

A

Rheumatoid arthritis

SLE

Uraemia

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Q

Sx of acute pericarditis

A

Chest pain

Worse on inspiration and lying flat

Pericardial rub

Fever

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Q

Acute pericarditis Ix

A

ECG saddle ST elevation

Viral serology

Blood cultures

FBC, U+E, Cardiac enzymes

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Q

Mx of acute pericarditis

A

Analgesia

Treat cause

Consider steroids / immunosuppressants

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Q

Problem with steroids and acute pericarditis

A

Steroids may increase risk of recurrence

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Q

Pericardial effusion definition

A

Fluid in pericardial sac

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Q

Causes of pericardial effusion

A

Any cause of pericarditis

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Q

Sx of pericardial effusion

A

SOB

Raised JVP

Ewart’s sign

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Q

Ewart’s sign

A

Bronchial breathing at left lower base

Q

Ix for pericardial effusion

A

CXR enlarged heart

Q

Mx of pericardial effusion

A

Treat the cause

Pericardiocentesis if tamponade

Q

Constrictive pericarditis definition

A

Rigid pericardium

Q

Causes of constrictive pericarditis

A

Idiopathic

Post acute pericarditis

Q

Sx of constrictive pericarditis

A

Right heart failre

Kussmaul’s sign

Quiet heart sounds

Q

Kussmaul’s sign

A

Paradoxical rise in JVP with inspiration

Q

Signs of right heart failure

A

Raised JVP

Hepatospleomegaly

Ascites

Oedema

Q

Ix for constrictive pericarditis

A

CXR: Small heart +/- pericardial calcification

Mx of constrictive pericarditis

Surgical excision

Cardiac tamponade definition

Pericardial effusion which increases intrapericardial pressure Poor ventricle filling and CO

Causes of cardiac tamponade

Acute pericarditis Aortic dissection Trauma

Sx of cardiac tamponade

Beck's triad Kussmaul's sign Tachycardia

Beck's triad

Raised JVP Hypotension Muffled heart sounds

Mx of cardiac tamponade

Call senior/specialist Pericardiocentesis