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Cardiovascular 4 > Diseases of the Pericardium > Flashcards

Diseases of the Pericardium Flashcards

1
Q

This is the layer of the pericardium that adheres to the outer wall of the heart

A

visceral pericardium

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2
Q

This is the outer layer of the pericardium that is very tough.

A

Parietal pericardium

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3
Q

This is the term that refers to the fact that the 2 ventricles share a fixed space limited by the rigid pericardium, so change in volume/pressure in 1 will result in a reciprocal change in the other.

A

Ventricular interdependence.

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4
Q

This is an exaggeration of the normal decline in systolic BP that occurs with insipration.

A

Pulsus paradoxus

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5
Q

How much must the decline in systolic BP be to be termed pulsus paradoxus?

A

> 10 mmHg

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6
Q

During inspiration, how does the negative pressure in the chest cause pulsus paradoxus?

A

increase in RV volume –> ventricular septum shift to L –> smaller LV filling –> small SV –> ↓ BP

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7
Q

Will BP increase or decrease in pericardial tamponade?

A

drop real big.

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8
Q

True or False: in constrictive pericarditis, there is the pulsus paradoxus effect as in tamponade because of the inability of the heart to expand and fill.

A

FALSE. in constrictive pericarditis, the negative intrathoracic pressure created during inspiuration is not easily transmitted through the rigid pericardial shell.

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9
Q

This is a signal of constrictive pericarditis because of increased blood in the thoracic and jugular veins from the inability of the RV to expand during breathing, thus, the jugulars distend during inspiration.

A

Kussmal sign

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10
Q

What are the 2 viruses to cause viral pericarditis?

A

echovirus and coxsackievirus group B

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11
Q

What is the bug to cause pericarditis in immunosuppressed patients?

A

TB

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12
Q

What are teh 2 bugs to cause non-TB bacterial pericarditis in immunocompromised pts, especially with severe burns and malignancies?

A

S. pneumo and Staph

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13
Q

Pericarditis can form a few days after what type of injury to the heart?

A

MI

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14
Q

What is the name of the syndrome where pericarditis forms 2 weeks to several months after an MI, and due to an autoimmune origin?

A

Dressler syndrome

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15
Q

Uremic pericarditis can from in pts with what type of problem?

A

Renal failure

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16
Q

What forms in the pericardium in neoplastic pericarditis?

A

Tumors

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17
Q

What are teh 3 things that can cause pericarditis assocaited with connective tissue diseases?

A

SLE, rheumatoid arthritis (RA) and progressive systemic sclerosis (PSS)

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18
Q

What are the 2 drugs to cause drug-induced pericarditis?

A

procainamide and hydralazine

19
Q

This is the stage of pericarditis where there is local vasodilation with transduction of fluid into the pericardial space, increased vascular permeability, and leukocyte exudation.

A

Acute pericarditis

20
Q

What is the type of pain felt by a pericarditis pt?

A

Sharp, pleuritic chest pain, that’s aggrivated by inspiration and coughing and is positional.

21
Q

True or false: there is a fever in acute pericarditis.

A

True

22
Q

Why is there a friction rub in pericarditis?

A

pericardial layers move against 1 another

23
Q

What shows up on EKG in pericarditis?

A

ST ↑ with PR ↓

24
Q

What are the 3 complications to pericarditis?

A

pericardial effusion, tamponade, constricitve pericarditis

25
Q

Case: pt presents with muffled heart sounds, Ewart sign (dullness to percussion of the L lung), enlarged cardial silhouette, and electrical alternans. Dx?

A

Pericardial effusion

26
Q

Case: pt presents with JVP, systemic hypotension, small & quiet heart, pulsus paradoxus, and sinus tachycardia. Dx?

A

Pericardial tamponade

27
Q

Case: pt presents with reduced CO, elevated systemic venous pressures, and Kussmaul sign. Dx?

A

Constrictive pericarditis

28
Q

What is the Tx of acute pericarditis?

A

Rest, NSAIDs, Colchicine, treat cause

29
Q

What is the Tx of pericardial effusion?

A

pericardiocentesis

30
Q

What is the Tx of pericardial tamponade?

A

pericardiocentesis

31
Q

What is the Tx of constrictive pericarditis?

A

cut it out. ha. hahaha. hahahhahhsahahahahahahahahhahah

32
Q

This is the form of pericarditis where noninfectious inflammatory diseases cause irritation of the parietal pericardium and serous effusion.

A

Serous pericarditis

33
Q

These are the 2 most frequent types of pericarditis, caused by acute MI, Dressler syndrome, and others.

A

Fibrinous and Serofibrinous pericarditis

34
Q

What is the morphology of the pericardium in fibrinous pericarditis?

A

dry, granular

35
Q

What is the morphology of the pericardium in serofibrinous pericarditis?

A

yellow-to-brown turbid fluid from WBC’s and RBC’s and fibrin

36
Q

What are the Sx to fibrinous and serofibrinous pericarditis?

A

friction rub and pain

37
Q

This type of pericarditis is caused by invasion of the pericardial space by microbes, leading to the formation of pus within the pericardial sac.

A

Purulent or Suppurative pericarditis

38
Q

What are the 2 manifestations of purulent pericarditis?

A
  1. spread to surrounding structures, leading to mediastinopericarditis
  2. scarring
39
Q

This is the form of pericarditis where a malignant neoplasm causes exudate with blood and fibrinous or suppurative effusion.

A

Hemorrhagic pericarditis

40
Q

This is the form of pericarditis where TB causes disabling, fibrocalcific, chronic constrictive pericarditis.

A

Caseous pericarditis

41
Q

This is a manifestation of pericarditis where the pericardial sac adheres to surrounding structures, leading to cardiac hypertrophy.

A

Adhesive mediastinopericarditis

42
Q

This is a manifestation of pericarditis where the heart is encased in a dense, fibrous or fibrocalcific scar that limits diastolic expansion and CO.

A

Constrictive pericarditis

43
Q

Which bone disorder can cause fibrinous pericarditis in 20-40% of the pts?

A

Rheumatoid arthritis

Cardiovascular 4 (9 decks)

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