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
