Pericardial Disease

Front 1

What is the most common cause of pericarditis and some other causes?

Back 1

Idiopathic; Pretty much anything can cause

Front 2

Most common SETTINGS of pericardial disease?

Back 2

post URI, concomitant systemic disease, open heart surgery, radiation, uremia

Front 3

Diff between pericardial effusion and tamponade?

Back 3

tamponade is an effusion that limits filling of heart and diminishes CO

Front 4

Pericardial constriction?

Back 4

scarring of the layers of pericardium that results in loss of flexibility, impaired filling of the heart

Front 5

What are the two biggest determinants as to whether pericardial effusion compresses the heart and affects function or not?

Back 5

Amount of fluid produced and the rate its produced (if slow, pericardium can stretch)

Front 6

Tamponade on CXR looks like what?

Back 6

Uniform bloating of the pericardium (like filling a water balloon)

Front 7

Best test for DX of cardiac tamponade?

Back 7

echo

Front 8

Cardiac tamponade has what effect on ventricular filling?

Back 8

severely limits because you can't ever get your diastolic pressure low enough

Front 9

What will cardiac tamponade show in the JVP?

Back 9

attenuated X descent (atria can't relax very far due to compression)

Front 10

Main physical findings of cardiac tamponade?

Back 10

JV Distension, Systemic Hypotension, Distant Heart sounds, paradoxical pulse

Front 11

EKG findings of tamponade?

Back 11

Atrial arrythmia, Electrica alternans, Low voltage;

Front 12

Why do you get pulsus paradoxus with tamponade?

Back 12

Inspiration increases venous return, greater RV volume shifts septum over, making LV volume smaller; Drop in SV leads to drop in BP

Front 13

Emergency measures to treat someon with acute tamponadE?

Back 13

IV fluid (increase venous return), Positive inotropes (better contractions allow for more filling from atria), Pericardiocentesis

Front 14

Big diff between restriction and tamponade with regards to onset?

Back 14

restrictive is chronic, usually secondary to some other insult; Tamponade can be acute or chronic;

Front 15

Physical findings of constrictive pericarditis?

Back 15

Elevated JVD, Kussmaul sign, 3rd heart sound, peripheral Edema

Front 16

What will the JVP of someone with constrictive pericarditis look like?

Back 16

prominent x and y descents

Front 17

Sx of someone with constrictive pericarditis?

Back 17

chronic history of fatigue and dyspnea

Front 18

CXR findings of someone with constrictive pericarditis?

Back 18

LA enlargement (only part not enclosed by shell, so expands), Pericardial calcification;

Front 19

EKG findings of someone with constrictive pericarditis?

Back 19

Atrial arrythmia, LA enlargement;

Front 20

Dx of pericardial constriction?

Back 20

MRI or CT

Front 21

Usual tx of pericardial constriction?

Back 21

surgical excision

Front 22

What functions better systolic or diastolic in constrictive pericarditis?

Back 22

Sytolic is fine, diastolic peaks early because its being constricted

Front 23

What is the big functional diff between constrictive pericarditis, and tamponade?

Back 23

Tamponade affects systolic and diastolic function, thus drops CO; Constrictive is only diastolic, so no drop in CO;