Pericardial Disease Flashcards
what is pericarditis
inflammation of the pericardium
what can cause pericarditis
viral infections -- coxsackie TB Post MI -- Dresslers syndrome SLE drugs -- hydralazine, procainamide
classical symptom of pericarditis
chest pain which is worse lying down and relieved by sitting forward
signs of pericarditis
pericardial rub
fever
tachypnoea / tachycardia
ECG changes in pericarditis
widespread saddle shaped ST elevation
tx pericarditis
NSAIDs
+ colchicine if viral / idiopathic
what is constrictive pericarditis
rigid, fibrotic pericardium
what can cause constrictive pericarditis
often idiopathic
may follow acute pericarditis
- particularly TB
signs + symptoms of constrictive pericarditis
Right ventricular failure – SOB, hepatomegaly, peripheral oedema, raised JVP + Kussmaul’s sign (raised JVP on inspiration)
muffled heart sounds
Loud S3 - pericardial knock
diagnostic Ix of constrictive pericarditis
echo
tx of constrictive pericarditis
pericardiectomy
what is a pericardial effusion
fluid in the pericardial sac
what causes a pericardial effusion
usually a complication of acute pericarditis
may also be caused by cancer
appearance of heart of CXR in a pericardial effusion
globular heart
echo findings in pericardial effusion
echo-lucent area around the heart
tx of a pericardial effusion
treat underlying cause
- NSAIDS for pericarditis
- chemo for cancer
pericardiocentesis for impending tamponade (a complication of effusion)
what is cardiac tamponade
fluid in pericardial sac accumulates until increased pressure causes decreased ventricular filling – decreased cardiac output
causes of cardiac tamponade
Trauma
Aortic dissection
Medical – warfarin, cardiac catheterisation
Pericardial effusion / pericarditis
what is Becks triad
hypotension
raised JVP
muffled heart sounds
- seen in cardiac tamponade
what type of pulse is seen in cardiac tamponade
pulsus paradoxus
- drop in BP during inspiration
ECG changes in cardiac tamponade
electrical alternans
- different amplitude of alternate QRS complexes
tx of cardiac tamponade
urgent pericardiocentesis
