504767
Description
Flashcards by ecmarchese, updated more than 1 year ago
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Created by ecmarchese
about 10 years ago
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| Question | Answer |
| Inflammatory or infectious process of the parietal and visceral layers of the pericardium | Pericarditis |
| What are the two types of pericarditis based on the onset, frequency, and symptoms? | Acute, constrictive |
| This onset occurs within 2 weeks of the offending condition, lasts up to 6, and painful due to dry friction rubbing | Acute pericarditis |
| Can a acute pericarditis lead to a pericardial effusion and if so why? | Yes, due to a obstructed lymphatic drainage |
| What causes acute pericarditis? | Acute injury, fibrin/ WBC/ endothelial cells are released and cover the pericardium, and friction between layers causing irritation and inflammation |
| What are the symptoms of acute pericarditis? | Chest pain, chills, fever, sweating |
| Purulent (pus filled) effusions results from bacterial infection and can lead to ________? | Constrictive pericarditis |
| Are 2D echoes reliable for documenting pericarditis? | No |
| What are some complications of acute pericarditis? | Pericardial effusion, tamponade, constrictive pericarditis |
| How do you determine pericarditis from pericardial effusion? | Evaluate fluid obtained during pericardiocentesis for infection |
| A thickened, fibrotic, and adherent pericardium restricting diastolic filling of the heart. | Constrictive pericarditis |
| What happens to the pericardium during constrictive pericarditis? | Undergoes fibrotic thickening, calcification, and fusion |
| How does most constrictive pericarditis start? | Most start with acute pericarditis/ pericardial effusion that results in fluid going into th pericardial cavity |
| What is constrictive pericarditis similar to? | Restrictive cardiomyopathy due to LV filling being restricted |
| What are some causes of constrictive pericarditis? | Idiopathic, TB, chronic renal failure, lupus, post cardiac surgery or pericardiotomy, post pericardial effusion, tumor involvement, recurrent pericarditis |
| What is the most common cause of constrictive pericarditis in the US? | Idiopathic. |
| What is the most common cause of constrictive pericarditis in other countries? | TB |
| What are the signs and symptoms of constrictive pericarditis? | JVD, pericardial knock, square ft sign, eval from cardiac cath, weakness/fatigue, weight loss, abdominal dissension, hepatomegaly, dyspnea, ankle edema |
| What is the hallmark finding for constrictive pericarditis? | Jugular venous distention |
| Rapid early diastolic filling followed by a prominent halt in flow. | Pericardial knock |
| Equalization of diastolic pressures in 4 chambers | Square root sign |
| Is the LV size normal with constrictive pericarditis? | Yes |
| Is a thickened pericardium hard to asses with echo? | Yes, because it normally appears bright |
| What will you find in 2D with constrictive pericarditis? | LAE due to impaired filling, LV and RV systolic function are normal, flat posterior wall motion, inter atrial/ ventricular septal bulge to the left during inspiration, dilated hepatic veins and no IVC collapse, |
| What do you see in m-mode with constrictive pericarditis? | LAE, flat LVPW motion in diastole, thickened pericardium, paradoxical septal motion, premature opening of PV |
| What will you most likely see in color flow with constrictive pericarditis? | MR & TR |
| What occurs after inspiration with constrictive pericarditis? | After inspiration, mitral velocities decreases tricuspid velocities increase |
| What do you look for in Doppler with constrictive pericarditis? | MR & TR, and evaluate for diastolic dysfunction |
| What are some complications of constrictive pericarditis? | Decreased cardiac output, CHF |
| What are some treatments for constrictive pericarditis? | Pericardiectomy, mortality rate 5-15% |
| Pericardial stripping | Pericardiectomy |
| Typically surrounds the ventricles, impedes diastolic filing, results in bi-atrial enlargement | Infiltrative cardiomyopathy (restrictive) |
| Typically surrounds entire heart, impedes diastolic filing, pressures within chambers equalize | Constrictive pericarditis |
| Why would a pt have no pericardium? | Congenital, surgically removed, (not common) |
| What are some things that occur when there is no pericardium? | Enlarges the heart, excessive LV motion (heart will rock), heart may be shifted to the left |
| Rare developmental anomalies that usually produce no symptoms and typically are located pertinent to the ribs & diaphram | Pericardial cyst |
| How do you diagnose a pericardial cyst accurately? | 2D echo, CT of the chest |
| What are some benign tumor involvements? | Pericardial clot, cyst, lipomas, or teratoma |
| What are two types of tumors? | Primary, benign tumors |
| Generally what type of tumor occurs more often? | Metastatic involvement, with carcinoid of the lung, breast, melanoma, lymphoma, and leukemia |
| What is the 2D appearance of metastases? | Echogenic structure without distinct borders located on pericardial surface (jagged edges) |
| What are metastatic involvements generally associated with? | Large effusions with or without tamponade |
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