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Cardio > Pericardial Disease > Flashcards

Pericardial Disease Flashcards

1
Q

Pericardial contains 2 layers

A
  1. Fibrous layer

2. Serous layer

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2
Q

Serous layer is divided into

A
  1. Visceral layer and parietal layer
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3
Q

Which layer adheres to the heat surface? What about the one that adheres to the fibrous layer?

A

Heart structure- visceral

Fibrous layer- parietal

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4
Q

Function of the pericardium

  1. Maintains _________ thus limiting acute expansion of chambers ‘
  2. Creates a closed chamber with sub atmospheric pressure that aids
  3. How does it protect the heart from infections?
  4. What else
A
  1. Ventricular compliance
  2. Aids atrial filling and lowers trans mural pressure
  3. Barrier
  4. Anatomically fixes the position of the heart within the chest activity
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5
Q

What do we see in EKG with pericarditis that is different in other diseases

A

Diffuse ST segment elevation and PR segment depression

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6
Q

Pericardial effusion with unstable hemodynamics

A

Pericardial tamponade

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7
Q

Pericardial tmaponade ekg findings

A

Low voltage, electrical alternans

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8
Q

Water bottle chest x-ray

A

Pericardial effusion

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9
Q

Becks triad

A
  1. Hypotension
  2. Elevated jugular venous pulse
  3. Muffled heart sounds
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10
Q

what happens to the pressure during inspiration in the pericardium

A

drops leading to a fall in right heart pressure and increased venous return to right heart

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11
Q

pericardial diseases

A
  1. congenital absence
  2. pericardial cyst
  3. inflammatory disorders
  4. pericardial hemorrhage
  5. neoplasms
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12
Q

inflammation of the pericardium

A

pericarditis

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13
Q

pericarditis ausculation

A

pericardial friction rub- scratchy, high-pitched sound

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14
Q

treatment of pericarditis

A

Nonsteroidal antiinflammatory agents, colchicine

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15
Q

pericardial tamponade

A

excess pericardial fluid - pericardial effusion

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16
Q

pericardial tamponade can be caused by

A

pericarditis, malignancy or hemorrhage

17
Q

EKG finds in pericardial tamponade

A

low voltage, electrical alternans

18
Q

what do we see in the echo of a pericardial tamponade

A
  • exaggerated respiratory variation of intracardiac flows, cardiac chamber collapse, dilated inferior vena cava
19
Q

signs of a pericardial tamponade

A
  1. pulsus paradoxus
  2. Beck’s triad
  3. tachypnea
  4. tachycardia
20
Q

pericardial tamponade hemodynamics:

  1. CVP: sharp ___ descent (atrial relaxation) and a blunted ____ descent (restricted emptying of right atrium due to RV diastolic resistance to filling)
  2. equalization of
  3. decreased (2)
  4. exaggerated respiratory variation in __________
A
  1. sharp x and blunted y descent
  2. equalization of diastolic intracardiac and intrapericardial pressures
  3. decreased (1) CO and (2) stroke volume
  4. trnasvalvular flows
21
Q

what is the outcome of pulsus paradoxus

A

decreased left heart filling during inspiration

22
Q

Pulsus paradoxus

  1. _____ drop in systolic blood pressure with inspiration
  2. inspiratory increase in venous return to right heart
  3. increased pericardial pressure leads the right heat unable to
  4. right ventricle expands at the expense of the left thereby sifting the septum to the
  5. pulmonary venous bed remains
  6. reduction in
A
  1. > 10 mmHg
  2. intacts
  3. expand
  4. shift to left
  5. remains compliant
  6. reduction in LV filling
23
Q

puslus paradox may be absent in some cases of tamponade

A

yep such as localized effusion or ASD

24
Q

pulsus paradox can also be seen in

A

RV infarction, PE

25
Q

treatment of pericardial effusion

A
  1. pericardiocentesis
  2. surgical drainage
  3. pericardial window if recurrent
26
Q

constrictive pericarditis

A

pericadial inflammation with thickened noncompliant pericardium

27
Q

common causes of constrictive pericarditis

A
  1. post-cardiac surgery

2. infection

28
Q

signs of constrictive pericarditis

A
  1. elevated JVP
  2. prominent y descent
  3. kussmaul’s sign
  4. pericardial knock
  5. sys. venous congestion
29
Q

constrictive pericarditis DX:

  1. CXR
  2. echo
  3. CT scan
  4. MRI
A
  1. CXR- pericardial calcification
  2. echo- interventricular septal shift
  3. CT- pericardial thickening
  4. MRI- thickening and shift
30
Q

constricitive hemodynamics

  1. prominent ____ descent of right atrial pressure due to rapid early diastolic flow from high pressure right atrium to the right ventricle
  2. filling pressures are
  3. equalization of
  4. sign
A
  1. y descent
  2. elevated filling pressures
  3. equalizations of pressures in all 4 chambers
  4. square root sign- dip and plateau
31
Q

constrictive pericarditis treatment

A
  1. diuretics

2. surgery for refractory symptoms

Cardio (26 decks)

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