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60 Cards in this Set
- Front
- Back
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what is normal intrapericradial pressure
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-5 to 5 mmHG
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the most common affliction of the pericardium is
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acute pericarditis
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t or f. uremia and drugs can cause pericarditis
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true
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acute pericarditis is most often caused by
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idiopathic
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what viruses are known to cause pericarditis
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influenza
varicella mumps hep b mononucleosis |
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TB is an improtant cause of pericarditis in people that are
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immunosuppressed
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what are the causes of purulent pericarditis
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pnemococcus
staph |
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when might people be susceptible by the purulent pericarditis
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immunocompromised as in burns or malignancies
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T or F pericraditis after MI is NOT improtant what is important is determining if pain is pericrarditis or another MI
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true
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what is the underlying cause of uremic pericarditis
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complication of chornic renal failure
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what kind of drugs cause pericarditis
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things that have lupus like synrome
procainamide (1A) hydralazine |
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what drugs induce lupus syndrome
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procainamide
hydralazine mtehyldopa isoniazid phenytonin |
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what other drugs that are non lupus could cause pericarditis
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anthracycline antineoplastic agents doxorubicin
minoxidil |
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what are four pathologies of pericarditis
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serous
serofibrinous suppurative hemorrhagic |
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what is the most common morphologic pattern in pericarditis
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serofibrinous
bread and butter |
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what causes hemorrhagic pericarditis
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TB
malignancy |
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what are clinical features with acute pericrditis
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pleuritic chest pain
fever pericardial friction rub ECG abnormalities |
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what is pleuritic chest pain
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pain with inspiration or cough
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a scrathcy pericardial friction rub tells you
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acute pericarditis
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what is the best way to hear rub
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patient leans forward and exhales
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what is a great way to tell pericarditis from MI
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ECG! see diffuse ST elevation
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why might you see PR segment depression
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abnormal atrial repol due to atrial epicardial inflammation
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what lab tests might you order
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PPD
serum tests for connective tissue diseases like SLE malignancy |
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what is best tx of pericarditis
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rest
pain relief but NO steroids |
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how do you treat purulent pericarditis
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drain adn Abx
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how do you treat uermic pericarditis
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dialysis
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what is normla volume pericardial space
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15-50ml
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why isnt' the relationship between volume and pressure NOT linear in pericardium
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because it is a relatively stiff structure so you get in trouble faster
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what might cause a sudden hemorrhagic
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chest trauma
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what are some symtpoms of large effusions
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difficutly swallowing
dyspnea hiccups |
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what are clinical features of large pericardial effusion
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soft heart sounds
reduced intesity of friction rub ewart's sign |
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what is ewart's sign
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decreased air movmeent over posterior left lng
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what would cause electrical alrternan
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large pericardial effusion as heart swings from side to side in the larg pericardial volume
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what is the most useful lab test to evaulate an effustion
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echo because you can find the fluid
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what are the msot common causes of tamponade
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neoplastic
postviral uremic pericarditis acute hemorrhage less commmonly acute pericarditis |
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rupture of LV free wall after MI, or dissecting aortic aneurysm, or blunt trauma could all cause
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tampanode
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hypotension can cause reflex
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tach
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what is beck's triad
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JV distention
hypotension small quiet heart all point to tamponade |
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why might your acute tamponade patient feel confused or agitated
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profound hypotension
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what is pulsus paradoxus
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decrease of systolic blood pressure during normal inspiration by 10mmHG
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pulsus paradoxus is an important clinical feature of
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cardiac tamponade
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on echo, an important indicator of high pressure pericardial fluid is
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compression of RV during diastole
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definitive dx for tamponade is
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cath -- also you can use therapeutic pericardiocentesis this way!
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what is tx tamponade
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got to get rid of fluid
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where do you stick needle for pericardiocentesis
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just below xiphoid to avoid coronary artery
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in tamponade the __ descent is blunted
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y
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what is y descent like in constrictive pericarditis
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rollercoaster y
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adenosine deaminase coudl help if you suspect
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TB
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do you see pulsus paradoxus in constrictive pericarditis
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no
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when do you see kussmaul's sign
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constrictive pericarditis
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what is common misdiagnosis of constrictive pericarditis
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hepatic cirrhosis
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what is kussmaul's sign
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increased venous return accumulates in intrathoracic systemic veins causeing jugual veins to be more distended during inspiration
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what does ECG of constrictive pericarditis show
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nonspecific ST and T wave anormlaities
atrial arrhythmias common |
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what is superior lab exam for constrictive
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MRI or CT to see the thickness of the pericardium
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dx constrictive is confirmed by
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cath
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what is square root sign
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constrictive pericarditis
roller y |
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constrictive looks like restrictive. why is important to distinguish
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constrictive is fixable-- get rid of the eggshell
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both effusion and constrictive pericarditis appear with clinical features of
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HF
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pericardiocentesis is indicated if pt develops cardiac _____
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tamponade
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elevated JV distention on inhalation is called
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kussmaul's sign
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