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26 Cards in this Set
- Front
- Back
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What is the pericardium?
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Conical fibro-serous sac that contains the heart and roots of the great vessels.
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Pericardial function?
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Isolates the heart from the rest of the mediastinum, lungs, and pleural spaces.
Provides lubrication allowing for normal rotation and translation, |
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How much pericardial fluid is normal?
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10-50cc. 10cc is standard.
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What is echo's role in pericardial disease?
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Diagnosis and management.
Easy to recognize with echo. Effusions can be drained with echo guidance. |
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What is pericarditis?
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Inflammation or infection of the pericardium which may or may not result in pericardial effusion.
May be acute, subacute, chronic. |
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Pericarditis etiologies?
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Idiopathic, viral, bacterial, trauma, Urremia (Renal failure), MI, Aortic dissection, Rheumatoid disease, radiation.
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What is dry pericarditis?
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Pericarditis without an effusion.
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How does a pericardial effusion become large?
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If fluid accumulates slowly, the pericardium will expand to accommodate large effusions.
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When do you see pericardial thickening?
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Chronic pericarditis, with or without effusion.
Constrictive pericarditis. |
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What are signs of pericarditis?
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Chest pain
S-T elevation Pericardial rub murmur. |
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How is pericardial effusion seen on echo?
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Echolucent space around heart.
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What determines the physiologic consequences of PE?
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Volume and rate of fluid accumulation.
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When do you see tamponade?
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When pericardial pressure exceeds intracardiac pressure. It impairs filling.
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How is pericardial thickening seen on 2-D?
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Increased echogenicity. Important to establish distribution by using several windows.
Can be measured in M-mode. Remember to carry out constrictive physiology measurements. |
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What is diffuse effusion?
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Symmetric and diffuse spread with clear separation between the parietal and visceral pericardium.
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Who gets loculated effusions?
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Post-op patients
Metastatic disease Recurrent pericardial disease Otherwise, loculated effusions are rare. |
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How do you differentiate between fat pad and PE?
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Anterior space with absence of posterior effusion most likely fat pad. So, if it looks like there is an effusion anteriorly, but nothing posterior, its a fat pad.
Zoom in, look for solid tissue like structures. |
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How do you differentiate between pleural and pericardial fluid?
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Pericardial effusions are anterior to descending aorta.
Pleural effusions are posterior to descending aorta. |
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When is it normal to see pericardial fluid.
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A clear space seen only in systole.
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aberrant
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abnormal or deviant
Aberrant means unusual and not socially acceptable. Ian's rages and aberrant behavior worsened. |
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Moderate effusion?
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100-500cc.
Posterior and anterior in systole and diastole. Less than 1cc. |
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When can fibrin strands be seen in PE?
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Long standing effusions.
Metastatic disease. |
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Where do pericardial effusions most commonly originate?
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Near the RA because it has the lowest pressure - effusion gets pushed to area with lowest pressure.
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Best place to visualize PE?
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Apical 4 or subcostal.
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What is the typical rate of accumulation of PE?
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Fast, and is usually moderate to large.
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In what 3 ways is echo helpful in making the diagnosis of tamponade?
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Size of PE
Location of PE Whether or not PE has a hemodynamic effect. |
