Pericardial Disease and Cardiovascular Tumors Flashcards
Fibrous Pericardium
Sac of dense CT surrounding the heart
Firmaly attached to diaphragm and adventitia of great vessels
Related to two lungs, pleura, and esophagus
Serous pericardium
Consists of parietal and visceral layers
Roots of great vessels
Pericardial essusion
Usually limited significance if chronic
Golubular enlargement of heart on X ray
A larger accumulation typically imappirs diastolic filling via pericardial tampondafe
Causes - CHF, hypoproteinemia, liver and kidney dz
Ex vs. trans
Ex - inflammatory, glucose ocntent lower, may have microorgs
Trans - no micro-orgs, glucose same as plasma
Hemopericardium
Sudden accumulation of blood in the closed space
How to detect tamponade
Pulus paradoxus - pulse dec during inspiration
Fibrinous and serofibrinous pericarditis
Causes - viral, uremia, chest radiation, post infarction dressler syndrome
Course - fibrin digested with resolution of the exudate or may become organized
SIgns - loud firction rub***, pain, sings of cardiac faiilure
Acute purulent or supprative pericarditis
Invasion of pericardial space by infecrive orgs
Thin and creamy pus
Urosepsis or direct infection
Const pericarditis is frequent outcome with organizaiton
Hemorrhagic pericarditis
Includes malignant pericarditis
Exudate in the pericardial space
Neoplastic involent of the pericardial sac from lung and breast cancer
TB pericarditis
Granulomatous inflammation with caseation of pericardial sac
Leads to fibrocalcific contrsiticve pericardtis
Chronic constrictive pericarditis
Associated with supprative, hemorrhagic, or hjealed TB
Cardiac fialure, no hypertrophy or dilation, pulsus paradoxus and diastolic knock on ausculation
DISTINUISH from restrictve CM
Enocardial benign
Myocardium benign
Valves - myxoma (carney) or papillary fibroelastoma (CVA)
Myo - Rhabdomyoam (TS), fibroma, hemangioma
Malignant Pericardium
Myocardium
Metastic from lung and breast
Primary pericardial mesothelioma
Primary angiosarcoma
Metastatic from kidney, lymphoma, melanoma
Cardiac myxoma
From mesenchyma/sensory nerve tissue of endocardial lining - calretinin positive
Ball valve on the Left atrial side and associated with syncopal episodes
Can repeatedly emoblize
Cardiac myxoma syndromes and dx
Echo
Carney complex - familial myxoma soft tissue and skin myxomas and spotted skin/Cushings
Carney complex - gene defect on chromosome 17
McCune Albright syndrome - GNAS1 gene…polyostotic fibrous dysplasia of bone, cafe au lait spots, endocrine overactivity
Carney complex
Auto dom
Myxomas of heart and skin
Hyperpigmentation of the ksin
Endocrine overreactivity
PRKAR1A mutation
Papillary fibroelastoma
Benign tumor of heart found on left sided hear tvalves that can cause embolic stroke
Cardaic fibroma
Rare - infants and childrne mostly
May cause ventricular dysrhytmia
IV spetum involvement worse
Rhabdomyoma
Most common cardiac tumor in children (T.S.)
Extracardiac hemangioma
Capillary hemangioma of skin is most common
Defomring craniofacial hemangiomas may endanger eyes, nasal
CS and IFN with PROPANOLO
OSW
KTS
PWS
OSW - telangiectasis composed of caps and veins…involve skin, oral, resp, GI, uro…auto dom
KTS and PWS - limb ossueous hypertrophy with DVT risk and pulm emobili….PWS from RASA 1 mutations
VHL and hereditary capillary hemangioma
VHL - cerebellar and retinal hemangioblastoma…also renal cell carincom and pheochromocytoma…chromosome 3
AVM…chromosome 5 deletion
Angiosarcoma and lymphangiosarcoma
Angio - head, neck, breast
Elderly, sun exposed
Radiation or aresnic
Lymph - persistent lymphedema
Kaposi sarcoma
Endothelial malignancy associated with HHV 8 and HIV
