Pericardial Diseases - Benjamin Flashcards
What are the three layers of the pericardium?
Where is the gap?
Fibrous pericardium
Parietal layer of serous pericardium
GAP
Visceral layer of serous pericardium
What is the main component of the pericardium? Why is that important?
Collagen
provides support AND flexibility
From which germ layer does the pericardium arise?
Mesoderm
How is the pericardium attached to the body wall?
Ligament attachments to the xiphoid, IVC, sternum, and spine.
What else is encased in the pericardium other than the heart?
Phrenic nerves
How much fluid does the pericardium typically contain? How much can it hold?
Normally, it holds about 50ml
Can stretch to hold 500ml in chronic volume overload
What is the main cause of acute pericarditis?
‘idiopathic’ but assumed to be viral
What are other causes acute pericarditis?
Radiation
Trauma
Fungal, Bacterial infection
Connective Tissue Disorders
What are symptoms of acute pericarditis?
Chest pain Pain improves leaning forward pain worsens laying down possibly hiccups possibly fever
What is the most prominent physical exam finding in acute pericarditis?
Friction rub
Can be intermittent
What are ECG finding in acute pericarditis?
Diffuse ST elevation
PR depression
T wave inversion at later stages
What is seen on a chest x-ray in acute pericarditis?
In uncomplicated pericarditis, nothing
How is acute pericarditis treated?
NSAIDS
Colchicine
Steroids (may increase relapse)
What is incessant pericarditis?
pericarditis that persists through treatment with symptom free periods of less than 6 weeks
What is hydropericardium?
What can cause it?
accumulation of serous fluid in the pericardium
congestive heart failure, hyponatremia, chronic kidney or liver disease
