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Cardiology Week 5 > Pericardial Diseases > Flashcards

Pericardial Diseases Flashcards

1
Q

what cells produce the fluid in the pericardial cavity?

A

epithelial cells

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2
Q

name three purposes of pericardial sac

A

keeps heart in place
serves as physical obstruction to infection from lungs
limits expansion of the heart size

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3
Q

what are the two most common causes of acute pericarditis?

A

viral and idiopathic

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4
Q

name four types of infections that can lead to acute pericarditis

A

virus
bacterial
TB
connective tissue disorders

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5
Q

what is the cause of post MI pericarditis immediately following an MI

A

inflammation from myocardium extends into the pericardial space

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6
Q

what is the cause of dressler syndrome following an MI? when does this occur?

A

thought to be autoimmune

at least 2 weeks after MI

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7
Q

what is fibrinous pericarditis?

A

when fibrin leaks out with inflammatory vasodilation and fibrin sets up shop in the pericardial space

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8
Q

what are four common causes of fibrinous pericarditis?

A

Virus
MI
Uremia
SLE

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9
Q

what is purulent pericarditis?

A

inflammatory migration of PMNs into the pericardial space

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10
Q

what is the usual cause of purulent pericarditis?

A

bacterial infections

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11
Q

what is tuberculous pericarditis?

A

when there is a tuberculosis infection that leads to granulomma formation in the pericardial cavity

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12
Q

name the four types of acute pericarditis based on pathology

A

serous
tuberculous
fibrinous
purulent

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13
Q

when you have pericarditis…what are the two options for long term development?

A

will either heal or scar and lead to constrictive pericarditis

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14
Q

name four symptoms of acute pericarditis

A

fever, chest pain thats worse when sitting up, non productive cough, dyspnea

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15
Q

what is something you can auscultate with acute pericarditis?

A

a friction rub from the parietal and visceral rubbing

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16
Q

what are the two important EKG findings early on with acute pericarditis?

A

concave ST segment elevation

PR interval depression

17
Q

what is the main treatment for acute pericarditis?

A

NSAIDs…specificall ibuprofen

18
Q

describe what causes constrictive pericarditis

A

chronis inflammation of the pericardium leads to calcification and thickening of the pericardial sac…this limits the expansion of the ventricles

19
Q

what is unique about the filling of the heart in restrictive pericarditis?

A

you will have a rush of filling in early diastole because as you get to mid/late the ventricles will start to be compressed by the pericardial sac

20
Q

what is a common infectious pericarditis to lead to constrictive pericarditis?

A

tuberculous pericarditis

21
Q

what are the signs/symptoms of constrictive pericarditis?

A

those of right heart failure…peripheral edema, ascites, fatigue

22
Q

name one thing you can auscultate with constrictive pericarditis

A

pericardial knock…3rd heart sound

23
Q

in pericarditis, is the jugular venous pressure increased decreased or stay the same?

A

increased or elevated

24
Q

what is Kussmauls sign?

A

when JVP remains elevated even with inspiration

25
Q

name two things that will happen with JVP in constrictive pericarditis

A

X and Y wave descents are steeper

elevated JVP throughout

26
Q

define cardiac tamponade

A

extreme form of pericardial constraint that is present throughout diastole, not just in mid to late like constrictive pericarditis

27
Q

what really causes cardiac tamponade?

A

accumulation of fluid in the pericardial sac leads to greater ventricular interdependence

28
Q

why can you see cardiogenic shock in cardiac tamponade?

A

negative intrathoracic pressure can be transmitted to the heart…so you get more venous return and as RV fills it bulges into LV since it cannot bulge out…this decreases LV volume and leads to diminished cardiac output

29
Q

what is becks triad for cardiac tamponade

A

hypotension, diminished heart sounds, elevated JVP

30
Q

what is the abnormality in JVP with cardiac tamponade? why?

A

blunted Y descent

this is because the Y descent is when ventricles are filling and this is problematic in cardiac tamponade

31
Q

what is pulsus paradoxus? why is it seen in cardiac tamponade?

A

when there is a larger decrease in pulse pressure than 10mmHg with inspiration…in cardiac tamponade the RV will shove on the LV leading to a lesser pulse with inspiration

32
Q

what will you see on EKG with cardiac tamponade? 2 things

A

tachycardia

electrical alternans

33
Q

what is electrical alternans? why is it seen in cardiac tamponade?

A

when QRS complexes change amplitude…seen because of the heart swinging in the pericardial fluid

34
Q

two treatments for cardiac tamponade

A

removal of fluid from pericardial sac and give fluid to maintain CO

also will do surgical repair if needed

35
Q

what is the treatment of cardiac tamponade called

A

catheter pericardiocentesis

Cardiology Week 5 (10 decks)

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