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60 Cards in this Set

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