Pericardial Disease Flashcards
1
Q
what are the 3 pathologies that make up pericardial disease
A
- pericarditis
- pericardial effusion
- tamponade
2
Q
what is pericardial effusion?
A
filling of pericardial space without compromised cardiac function
slow build up of fluid in pericardial space up to 2L is well tolerated and causes minimal compromise as the pericardium stretches
3
Q
aetiology of pericardial effusion?
A
any cause of pericarditis
4
Q
clinical features of pericardial effusion
A
- often asymptomatic or dull chest ache
- SOB
- raised JVP w absent Y descent
- mild sinus tachycardia
- Ewert’s sign:bronchial breathing at left base
- left lower lung field partially collapsed due to pressure from effusion, with corresponding dullness
5
Q
Ix of pericardial effusion
A
- CXR
- enlarged heart
- ECG
- low voltage QRS
- alternating QRS amplitude (electrical alternans)
- Echo
- effusion seen
- pericardial fluid for culture
6
Q
Mx of pericardial effusion
A
- treat cause
- pericardiocentesis = diagnostic or therapeutic
7
Q
complications of pericardial effusion
A
- compromised cardiac function–> tamponade
- if pressure matches diastolic pressure –> impaired filling and reduced CO
8
Q
pathology of tamponade
A
rapid accumulation of fluid can lead to sudden compromise –> life threatening cardiac emergency
9
Q
aetiology of tamponade
A
- any cause of pericarditis
- dissection
- warfarin
- trauma
10
Q
signs of tamponade
A
- BECK’S TRIAD
- hypotension
- quiet heart sounds
- raised JVP
- pulsus paradoxus
- pulse fades on inspiration
- Kussmaul’s sign
- distension of jugular veins & elevation of JVP during inspiration
11
Q
Ix of tamponade
A
- ECG
- low voltage QRS
- electrical alternans
- Echo
- diagnostic; free zone around heart
- CXR
- large heart
12
Q
Mx of tamponade
A
urgent pericardiocentesis
- send fluid fro cytology, ZN stain and culture
