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Cardiology > Pericardial diseases > Flashcards

Pericardial diseases Flashcards

1
Q

What are the causes of acute pericarditis?

A
  1. viruses - coxsackie, EBV, flu
  2. TB
  3. bacteria - pneumonia, rheumatic fever, staph, strep
  4. Post MI - Dressler’s syndrome
  5. Uraemia - ‘fibrinous’ pericarditis
  6. SLE, sarcoidosis
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2
Q

What is the typical presentation of pericarditis

A

pleuritic chest pain relieved by sitting forward and worse on inspiration
non-productive cough
SOB and fever
pericardial rub

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3
Q

What ECG changes can be seen in pericarditis?

A

saddle sT elevation
PR depression
widespread changes

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4
Q

What may XR show in pericarditis?why

A

cardiomegaly due to pericardial effusion

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5
Q

Rx of pericarditis

A
  1. treat cause
  2. NSAIDs
  3. colchicine if recurring
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6
Q

What are the clinical features of a pericardial effusion

A
  • SOB
  • raised JVP
  • Bronchial breathing at L base
  • signs of cardiac tamponade
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7
Q

What investigations point to a diagnosis of pericardial effusion?

A
  1. CXR - enlarged globular
  2. ECG - low voltage QRS, alternating QRS morphology
  3. Echo
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8
Q

What is the treatment of pericardial effusion?

A

treat the cause

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9
Q

What can cause constrictive pericarditis?

A

any cause of pericarditis - is a complication of it

TB

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10
Q

What are the sx of constrictive pericarditis?

A

SOB

oedema

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11
Q

What are the signs of constrictive pericarditis?

A 
That of RHF: raised JVP, ascites, hepatomegaly
\+ve Kussmaul's sign 
Pericardial knock 
S3 
JVP w prominent X and Y descent
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12
Q

What is kussmauls sign

A

JVP rising paradoxically w inspiration

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13
Q

What can be seen on XR in constrictive pericarditis?

A

pericardial calcification

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14
Q

What is the treatment of constrictive pericarditis?

A

surgical excision

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15
Q

what is cardiac tamponade?

A

accumulation of pericardial fluid leading to raised intrapericardial pressure -> poor ventricular filling -> reduced CO

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16
Q

What are the features of cardiac tamponade?

A

BECKS triad:

  1. hypotension
  2. raised JVP
  3. Muffled heart sounds
17
Q

What are the causes of cardiac tamponade?

A

pericarditis
aortic dissection
haemodialysis

18
Q

What is diagnostic of cardiac tamponade?

A

echo

19
Q

what is the treatment of cardiac tamponade

A

urgent pericardiocentesis + culture fluid

20
Q

Explain how cardiac tamponade and constrictive pericarditis differ

A

Tamponade
JVP: Absent Y descent
PP: present
K’s sign: absent

CP
JVP: X + Y present 
PP: absent 
K's sign: present 
Features: pericardial calcification

Cardiology (13 decks)

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