Small Group: Myocarditis/Pericarditis Cases

Question 1

The interventricular septum is usually much thicker in ___________.

Answer 1

hypertrophic obstructive cardiomyopathy

Question 2

Why do standing and valsalva increase the sound of hypertrophic systolic murmurs?

Answer 2

Because both maneuvers decrease venous return to the heart–valsalva by increasing intrathoracic pressure and standing by causing the blood to pool in the legs–and decreased venous return increases the pressure gradient between the left ventricle and the aorta, thus amplifying the murmur.

Question 3

What are some presenting signs and symptoms of tamponade?

Answer 3

Jugular venous distention (due to increased pressure on the right ventricle), hypotension (because the left ventricle isn’t receiving enough blood), and tachycardia (because the sympathetic response

Question 4

What physical exam finding might be present in those with pericarditis?

Answer 4

Pericardial rub or scratching sound with the heart beat

Question 5

What ECG sign is unique to pericarditis?

Answer 5

PR depression