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Cardiology IPAP > Tamponade > Flashcards

Tamponade Flashcards

1
Q

What happens to JVP waveform w/ tamponade?

A

Lose “Y” descent (RV filling loss)

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2
Q

Becks triad consist of?

A

D- Distended JVP
D- Distant Heart sounds
D- Decreased BP

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3
Q

What pulse is associated w/ tamponade?

A

Pulsus paradoxus

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4
Q

What is pulsus paradoxus?

A

> 10mmHG drop of SBP during NL inspiration

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5
Q

What can you expect on a EKG of tamponade or a very LRG effusion?

A

Electrical alternans

Low voltage

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6
Q

Electrical alternas is due to

A

Heart swinging back and forth beat to beat

Closer to chest then away

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7
Q

Why is echo beneficial for tamponade?

A

Can visualize cardiac chamber compression

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8
Q

What are inflammatory signs associated with pericarditis?

A

Pleuritic chest pain
Friction Rub
Fever +/-
Diffuse ST elevation

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9
Q

Tamponade + inflammatory signs is?

A

DX of acute idiopathic pericarditis

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10
Q

Large effusion w/ no inflammatory S/S or tamponade is?

A

Chronic idiopathic pericardial effusion

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11
Q

Tamponade w/out inflammatory S/S is?

A

Malignant effusion

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12
Q

DX tests/eval of tamponade include

A

Cardiac cath + same Dx tests as pericardial effusion

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13
Q

What is the benefit of performing a cardiac cath on a pt w/ tamponade?

A

Can directly measure intercardial/pericardial pressures

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14
Q

Causes of Exudates? M-PIC

A

M- Malignancy
P- Post-pericardiotomy
I- Infection
C- Collagen vascular DZ

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15
Q

Causes of transudate? HURT

A

H- Hypothyroidism
U- Uremia
R- Radiation
T- Trauma

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16
Q

Most important TXT of tamponade is? (2)

A

TXT underlying cause

Aggressive fluid management

17
Q

What is pericariotomy?

A

Balloon used to create window for drainage

18
Q

Difference between Tamponade and Constrictive PC?

A

Tamponade - Fluid under pressure

Constrictive PC - Scarred/rigid pericardium

19
Q

What happens with impaired diastolic filling?

A

Elevated venous pressures > systemic & plum congestion

Impaired SV > Decreased CO

20
Q

What are some common S/S between Tamponade and constrictive PC? “DR. PATHH”

A 
D - Distended JVP
R - Rales
P - Peripheral Edema
A - Ascites
T - Tachycardia
H - HOTN
H - Hepatomegaly
21
Q

What are the chronic inflammatory changes that happen w/ constrictive PC?

A

F- Fibrosis
A- Adherence
T- Thickening
C- Calcification

22
Q

What does constrictive PC mimic?

A

R sided heart failure

23
Q

What does constrictive PC essentially do to the heart filling?

A

Impairs diastolic filling WITHOUT effecting systolic filling

24
Q

What are RHF S/S?

A

Increased Systemic venous pressure
Ascites
Hepatospleomegaly
Peripheral edema

25
Q

Decreased CO leads to?

A

Dyspnea
Fatigue
HOTN
Tachycardia

26
Q

What are 3 unique findings w/ someone who has constrictive PC?

A

Precording knock
Kussmauls
Cachexia

27
Q

When is the precordial knock?

A

Early diastolic - Slightly before S3 murmur found in constrictive PC

28
Q

What can you expect to see on an EKG of constrictive PC?

A

Non-specific ST & T wave changes
Tachycardia
Low voltage
A-fib

29
Q

What are the benefits of an ECHO TTE w/ constricitive PC?

A

Diagnostic
Can locate septal bounce
Measure thickening

30
Q

What is a septal bounce?

A

It is intraventricular septal changes w/ respiration found in constrictive pericarditis

31
Q

What unique test can you use when DX constrictive PC?

A

CMR

32
Q

Why is CMR a useful test when DX constricitive PC?

A

Can differentiate pericardial thickening from SML effusion or prep a pericardiectomy candidate

33
Q

What is the only effective TXT of constrictive PC?

A

Pericardiectomy (S/S doesnt resolve immediately)

34
Q

What determines the outcome of pericardiectomy?

A

Depends on LV dysfx, (1 in 5 die - 20%)

35
Q

What does an impaired LV lead to?

A

Decreased SV, CO, and tachycardia

36
Q

What is MC cause of constrictive PC?

A

Idiopathic/viral

37
Q

What pericarditis does constrictive PC rarely follow?

A

Acute PC

Cardiology IPAP (20 decks)

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