Pericardium 12.01.24

Question 1

Do the great vessels of the heart lie within or outside of the pericardium??

Answer 1

Within the pericardium

Question 2

Is the left atrium mainly within or outside of the pericardium?

Answer 2

Mainly outside the pericardium

Question 3

Describe tamponade physiology

Answer 3

Mechanical function restrains the filling volume of the heart
Similar properties to rubber initially stretchy but becomes stiff at higher tension
Thus pericardial sac has a small reserve volume
If this volume is exceeded the pressure is translated to the cardiac chambers
Small amount of volume added to space has dramatic effects on filling but so does removal of a small amount – Tamponade physiology

Question 4

In the uk what commonly causes pericarditis

Answer 4

Viruses

Question 5

What are some neoplastic non-infectious causes of pericarditis

Answer 5

SECONDARY metastatic tumours (common, above all lung and breast cancer, lymphoma)

Question 6

What is the main clinical presentation of pericarditis

Answer 6

Severe chest pain

Question 7

Where is pain of the pericardium said to radiate?

Answer 7

Radiates to arm more specifically trapezius ridge (co-innervation phrenic nerve)

Question 8

What is seen in ecg of pericarditis

Answer 8

Diffuse ST segment elevation
Concave ST segment (can resemble acute injury pattern of STEMI)
No reciprocal ST depression
Saddle shape ST
PR depression