Pericardial dz

Question 1

PE findings pericardial effusion

Answer 1

 PE: changes w large amount of effusion → cardiac tamponade
o Jugular venous distension +/- pulsation = ↑ systemic venous pressure
o Weak/variable pulse: ↓ pulse pressure, pulsus paradoxus
o Muffled heart sounds + ↓ palpable precordial impulse
o LA tear: systolic murmur from MR
 Arrhythmias: sinus tachycardia 2nd to ↓CO

Question 2

PE findings constrictive pericarditis

Answer 2

 Similar to pericardial effusion
o Except ↓ heart sounds less common, no pulsus paradoxus
 Gallop sound may be present
 Pericardial knock: uncommon in dogs (Hu)
o Sudden deceleration of ventricular filling

Kussmaul’s sign

Question 3

PE findings acute pericarditis

Answer 3

 Pericardial friction rub: pericardium inflammation → friction of walls rubbing against each other
o To and fro
 Superficial, creaky, scratchy character → walking on dry snow
 3 components: 1 systolic, 2 diastolic
* Can be only during ventricular systole
* May have a component during atrial systole = biphasic
* Or ventricular diastole = triphasic
o Lower L sternal edge + cardiac apex
o Independent of respiratory cycle, can be louder in inspiration