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19 Cards in this Set

  • Front
  • Back
What are the 3 roles of the pericardium?
Fixes heart in mediastinum; prevents over dilatation;
infection barrier
What is acute pericarditis?
Inflammation of the pericardial layers via multiple etiologies that are infectious (viral,TB, G+ bacteria) or noninfectious.
Which of the following is not a form of Noninfectious Acute Pericarditis: Dressler, MI, Uremia, Radiation/Drug Induced, Connective Tissue Disease, Neoplastic disease, Staphylococcus Aureus
Describe the 3 stages of the inflammatory process of pericarditis.
1. local vasodilation leads to transudation;
2. increased vascular permeability causes protein leakage;
3. leukocyte exudation
Distinguish Pathologic appearance of serous, Serofibrinous, Suppurative, and hemmoragic pericarditis.
Serous - few PMNs; Serofibrinous - plasma proteins "bread and butter"; Suppurative - pus exudate with erythematous serosal surface; hemmoragic - blood
How does the pain in pericarditis differ from Myocardial ischemia?
pleurtic, positional and sharp
what are the EKG abnormalities often seen in pericarditis?
diffuse ST segment elevation and PR segment depression
What is acute pericarditis' treatment? (Viral/Post MI/Purulent/Uremic)
Idiopathic/Viral = rest + pain relief; Post MI = avoid other NSAIDs except ASA; Purulent requires ABX and drainage; Uremic = Dialysis
What is Pericardial Effusion?
abnormal accumulation of fluid in the pericardial cavity.
What 3 factors determines the initial presentation of symptoms in pericardial effusion?
volume of fluid, rate fluid accumulates, compliance of the pericardium
What is one of the most useful noninvasive methods to quantify pericardial effusion and evaluate for cardiac tamponade?
Echocardiography (as little ast 20 ml)
What is Treatment for Pericardial Effusion?
IF Cause is known, treat that; if not evident then fluid removal.
What is cardiac Tamponade?
Abnormal accumulation of fluid in the pericardial cavity under high pressure causing cardic compression.
Describe the structural consequences of Cardiac Tamponade on the heart and vasculature.
Right sided Heart failure with JVD and pulmonary congestion.
What physical sign is important in recognizing Cardiac Tamponade?
Pulsus paradoxus (Systolic BP drops cyclically with inspiration)
What is blunted in RA pressure tracing in cardiac tamponade?
y descent
What is the pathogenesis and physiologic consequence of constrictive pericarditis?
Post pericardial effusion, fluid undergoes organization and fusion of the 2 layers. This is followed by scar formation, which stiffens the pericardium. This rigid, stiff pericardium impairs normal filling of the cardiac chambers.
What is constrictive pericarditis often mistaken for?
hepatic cirrhosis, or intraabdominal tumor
How is constrictive pericarditis treated?
Surgical removal of the pericardium.