PERICARDIAL DISEASES

Question 1

a double-walled sac containing the heart and the roots of the great vessels.

Answer 1

Pericardium

Question 2

If the Pericardium Cavity becomes full of fluid it will compress the heart and lead to

Answer 2

pericardium tamponade

Question 3

ACUTE PERICARDITIS

Answer 3

Sudden onset CP (severe)
CP varies with position and breathing

Pericardial rub on cardiac exam
EKG- Diffuse ST elevation

Question 4

ACUTE PERICARDITIS COMMONEST CAUSES:

Answer 4

1. Viral illness
2. Connective tissue or autoimmune diseases
3. Uremia
4. Metastatic tumors

Question 5

__________ is a type of pericarditis (an inflammation of the sac surrounding the heart, the pericardium) usually lasting < 6 weeks. It is the most common condition affecting the pericardium.

Answer 5

Acute pericarditis

Question 6

ACUTE PERICARDITIS Responds to:

Answer 6

anti-inflammatory agents
(Ibuprofen, aspirin)
*colchicine

Question 7

PERICARDIAL EFFUSION

Answer 7

occurs when too much fluid builds up around the heart.

Question 8

PERICARDIAL EFFUSION

Common Causes

Answer 8

1. Viral or acute idiopathic pericarditis
2. Metastatic malignancy
3. Uremia
4. Autoimmune Disease
5. Hypothyroidism

Question 9

Small effusions without high intrapericardial
pressure may be asymptomatic

Large effusions with high intrapericardial pressures cause ___________ where myocardial compression impairs diastolic filling

Answer 9

cardiac tamponade

Question 10

PERICARDIAL EFFUSION WITH

TAMPONADE CAUSE

Answer 10

Rapidly accumulating moderate sized or large

effusions

Question 11

Pericardial effusion with _____________ is called cardiac tamponade

Answer 11

enough pressure to adversely affect heart function

Question 12

PERICARDIAL EFFUSION WITH

TAMPONADE PRESENTATION

Answer 12

Decreased RV diastolic filling during inspiration

Distended neck veins

Inspiratory decrease in arterial pressure
(Paradoxical Pulse)***

Question 13

ECHOCARDIOGRAM IN TAMPONADE

Answer 13

• Collapse of the right atrium and right ventricle in end-diastole
• Dilation of the inferior vena cava without
the normal >50% reduction during inspiration

Question 14

ECG IN CARDIAC TAMPONADE

Answer 14

Low voltage with sinus tachycardia

Electrical alternans with sinus tachycardia

Question 15

CONSTRICTIVE PERICARDITIS is a ____ disease

Answer 15

Chronic

Question 16

CONSTRICTIVE PERICARDITIS CAUSE

Answer 16

Scarring & loss of elasticity of the pericardium

Question 17

CONSTRICTIVE PERICARDITIS ETIOLOGIES

Answer 17

Idiopathic, after cardiac surgery, radiation, infectious (TB)

Question 18

CONSTRICTIVE PERICARDITIS PATHOPHYSIOLOGY

Answer 18

Impaired diastolic filling with normal systolic function

Question 19

CONSTRICTIVE PERICARDITIS PRESENTATION

Answer 19

Markedly elevated jugular venous pressure**, tachycardia

Often with hepatomegaly,edema, ascites

Question 20

DIAGNOSIS OF CONSTRICTIVE

PERICARDITIS

Answer 20

Transthoracic echo- see pericardial thickening
MRI/CT- Calcified Pericardium
Cath

Question 21

CATHETERIZATION IN CONSTRICTIVE PERICARDITIS

Answer 21

1. Dip and Plateau (“square root sign”) during diastole.

2. Equalization of diastolic pressures between LV and RV.

Question 22

A chronic disease that usually takes:

Answer 22

considerable time to develop

Question 23

Cardiac silhouette usually __________but encased by thickened pericardium

Answer 23

normal size

Question 24

Lungs not congested because constriction selectively impairs _____________

Answer 24

filling of right ventricle

Question 25

Cousmals sign

Answer 25

deep inspiration–>
Bulge/Inc in Venous Pressure on Right Side JVD
NO paradoxical pulse (where LV affected)

Question 26

CONSTRICTIVE PERICARDITIS Treatment:

Answer 26

Surgical stripping of the pericardium