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Year 2 > Pericarditis > Flashcards

Pericarditis Flashcards

1
Q

How many layers form the pericardium

A

2

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2
Q

Where is the visceral pericardium located

A

Next to epicardium

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3
Q

How thick is the fibrous parietal layer

A

2mm

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4
Q

What is the pericardium made of

A

Collagen and elastin fibres

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5
Q

How much serous fluid is contained between the two layers

A

50ml

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6
Q

Role of serous fluid in pericardium

A

Lubriates surface of the heart

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7
Q

Is the left atrium located in the pericardium

A

Mainly outside

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8
Q

Mechanical función of the pericardium

A

Restrains filling volume of the heart

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9
Q

What happens to the stretchability of the pericardium at higher tension

A

Stiffer

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10
Q

What happens if we exceed the 50mL serous fluid in the pericardium

A

Translates pressure to cardiac chambers

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11
Q

What is the Tamponade physiology of the pericardium

A

Small amount of volume added to space has dramatic effects on heart filling

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12
Q

How does chronic pericardial effusion effect the chambers

A

Reduces diastolic filling of chambers

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13
Q

What is acute pericarditis

A

Fibrous material is deposited into pericardial space and pericardial effusion occurs

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14
Q

How is clinical acute pericarditis diagnosed

A

2 of 4:

  1. Chest pain
  2. Friction rub
  3. ECG changes
  4. Pericardial effusion
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15
Q

What is the most common cause of pericarditis

A

Viral caused - Coxsackie B and echovirus

Herpesvirus

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16
Q

How long does viral pericarditis last

A

Short time + causes pain

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17
Q

When does bacterial pericarditis usually occur

A

Early postoperative infection (thoracic surgery)

RARELY: Septicaemia or Pneumonia

S. Aureus in HIV patients

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18
Q

Bacteria vs viral

A

Bacterial can be fatal

19
Q

How common are fungal pericarditis

A

Rare - Drug addicts + immunocompromised patients

20
Q

What two species cause fungal pericarditis

A
  1. Histoplasmosis

2. Coccidioidomycosis

21
Q

What are non-infectious causes of pericarditis

A
  1. Autoimmune (rheumatoid arthiritis)
  2. Primary Tumours (lung, breast and lymphoma)
  3. Uraemia
22
Q

What is the most common type of bacterial pericarditis

A

Tuberculosis Pericarditis

23
Q

In what two conditions can non-infectious pericarditis have an early onset

A
  1. Direct injury (oesophageal perforation + penetrating thoracic injury)
  2. Indirect Injury (radiation injury)
24
Q

What patients tend to be effected by pericarditis the most

A

Higher in young

25
Q

Chest pain in pericarditis

A
  1. Sharp, CENTRAL chest pain
  2. exacerbated on movement/lying down
  3. Pain felt in left anterior chest or epigastrium
  4. Pain radiates to arms
  5. Relieved by sitting forward
26
Q

Other symptoms of pericarditis

A
  1. Dyspnoea
  2. Cough
  3. Hiccups
  4. Skin rash, joint pain, eye Sx, weight loss
27
Q

Differential diagnosis of Pericarditis

A
  1. Angina

2. Pleurisy

28
Q

Classic clinical signsof pericarditis

A
  1. Pericardial rub occurring heard at the diaphragm via stethoscope (atrial, ventricular systole and ventricular diastole)
  2. Sinsu tachycardia
  3. Fever
  4. Signs of effusion
29
Q

What is diagnostic for pericarditis

A

ECG - Concaving ST elevation (differentiate from MI as it will show up in leads other than anterior or inferior leads)

Also:
Bloods
CXR (may demonstrate cardiomegaly)
Echocardiogram (confirm cardiomegaly on CXR)

30
Q

Characteristics of an ECG in pericarditis

A
  1. Diffuse ST segment elevation
  2. Concave ST segment
  3. No ST depression
  4. PR depression
31
Q

In blood tests, what should we see in FBCs

A
  1. Increased in WCC + mild lymphocytosis
32
Q

In blood tests, what should we see in ESR and CRP

A

High ESR

ANA in young females

33
Q

In blood tests, what should we see in troponin levels

A

Elevation - myopericarditis

34
Q

In blood tests, what should we see in CXR

A

Enlargement of cardiac silhouette - rules out effusion

35
Q

How is Pericarditis manages

A
  1. Sedentary activity oil ECG normalises
  2. NSAID (Ibuprofen 600mg or Aspirin 750-1000mg)
  3. Colchicine (0.5 mg)
36
Q

How does Colchicine help

A

Reduces recurrence

37
Q

When is Colchicine activity limited

A

Nausea and diarrhoea

38
Q

Long-term consequences of major pericarditis

A
  1. fever
  2. Pericardial effusion
  3. Cardiac tamponade
  4. Lack of response to aspirin + NSAIDs
39
Q

Long-term consequences of minor pericarditis

A
  1. Myopericarditis
  2. Immunosuppression
  3. Trauma
  4. Oral anticoagulant therapy
40
Q

How common is cardiac tamponade

A

Rare - usually effects acute idiopathic pericarditis

41
Q

What population does Tuberculous effusion Pericarditis effect

A

HIV positive -> leads to constrictive pericarditis

42
Q

What is constrictive pericarditis

A

Pericardium becomes thick, fibrous and calcified - interferes with the diastolic filling of the heart

43
Q

What is pericardial effusion

A

Collection of fluid in the space of pericardial sac

44
Q

What is tamponade

A
  • when volume exceeds 50mL and impairs ventricular filling

Year 2 (155 decks)

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