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Cardiology > Pericardial Dz > Flashcards

Pericardial Dz Flashcards

1
Q

How fluid does pericardium have?

A

15-50ml

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2
Q

What is pericarditis?

A

inflammation of the pericardium

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3
Q

What are the different classifications of pericarditis?

A

-acute (6mo)

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4
Q

What are the different etiologies?

A
  • infectious

- nonfectious

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5
Q

What is infectious?

A
  • viral: most likely; post URI
  • bacterial: sepsis
  • mycotic: impaired immune system; T cells so increased rate in HIV patients
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6
Q

What is noninfectious?

A
  • MI
  • Neoplastic
  • myxedmea: hypothyroidism
  • DRESSEL SYDNROME
  • autoimmunity: lupus
  • meds; hydralazine
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7
Q

What is Dressel’s syndrome?

A
  • d/t injury to HEART or PERICARDIUM
  • 2wks after MI
  • TRIAD:
    1) low fever
    2) pleuritic chest pain: sharp
    3) pericardial effusion
  • autoimmune: heals on it’s own
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8
Q

What is acute pericarditis?

A

80% are idiopathic/viral

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9
Q

Who does acute pericarditis affect?

A

young adults

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10
Q

Tx of acute pericarditis?

A
  • self limiting
  • bed rest
  • NO anticoagulants b/c it can x and increase risk of bleeding
  • watch out for pericardial effusion if it gets worse
  • if pt insistent:
  • -First line:
  • —NSAIDs (idiopathic, viral, autoimmune)
  • — ASA
  • – colchicine (works well w/ gout)
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11
Q

How long does acute pericarditis last?

A

4 days to 4 wks

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12
Q

What do you have to watch out for in acute pericarditis?

A

increased inflammation can lead to pericardial effusion

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13
Q

PE of acute pericarditis?

A
  • severe, sharp chest pain
  • -worse w/ cough
  • -better w/ sitting up
  • PERICARDIAL FRICTION RUB
  • -high pitched, scratching upon inspiration
  • -heard better in L decubitus
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14
Q

Lab for acute pericarditis?

A

-increased ERS

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15
Q

EKG for acute pericarditis?

A
  • WIDE ST segment
  • inverted T
  • PR depressed
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16
Q

PE of pericardial effusion

A
  • distant heart sounds
  • +/- pericardial friction rub (it may be filled with too much water)
  • dullness under scapula (b/c it’s filled with water in the HEART not lungs)
17
Q

CXR of pericardial effusion?

A

water bottle shape (heart is in a WATER bag)

18
Q

EKG of pericardial effusion?

A
  • PR depressed

- small R wave –> large R wave –> small R wave

19
Q

Echo for pericardial effusion?

A

GOLD STANDARD

  • estimates amount of fluid
  • where the fluid is localized
  • how much water is pressing on the heart
20
Q

What is cardiac tamponade?

A
  • fluid/blood building up between heart and endocardium
  • 911 EMERGENCY
  • reduces CO
21
Q

Cx of cardiac tamponade?

A
  • neoplastic inflitration of pericardium/lungs
  • dissecting aortic aneurism
  • idiopathic pericarditis
22
Q

PE of cardiac tamponade for acute?

A

acute:

  • dyspnea (b/c not enough CO)
  • cold clammy hands (b/c not enough perfusion)
23
Q

PE of cardiac tamponade for slow?

A

slow:

  • may look like RHF
    • JVD
    • dyspnea
24
Q

PE of cardiac tamponade in general?

A
  • weak pulses
  • tachycardia (b/c of low SV so it tries to perfuse by beating faster)
  • FALLING ARTERIAL BP
  • INCREASED VENOUS PRESSURE
  • PARADOXICAL PULSE (when they breathe in, there’s no pulse heard/felt)
25
Q

Tx of cardiac tamponade?

A
  • pericardiocentesis
    • can be used at tx AND diagnostic
    • has needle/aspiration and catheter
26
Q

Send diagnostic pericadiocentesis to lab to check for..?

A
  • viral
  • culture
  • tumor cells
27
Q

What is chronic constrictive pericarditis?

A

the pericardial cavity that has granulation and scarring

28
Q

Cx of chronic constrictive pericarditis?

A

healing processes from acute fibrinous pericarditis (ie) TB

29
Q

PE of chronic constrictive pericarditis?

A
  • SOB
  • weakness
  • fatigue
  • wt loss
  • looks sick
  • MAY look like LIVER CIRRHOSIS but NO distended neck veins
30
Q

What is test for chronic constrictive pericarditis?

A

CT/MR

31
Q

Tx for chronic constrictive pericarditis?

A

surgery

32
Q

What can chronic constrictive pericarditis look like?

A
  • pericardial cyst
  • tumors
  • blood clots

Cardiology (10 decks)

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