Cardio - Pericardial Diseases Flashcards Preview

Small Animal Medicine > Cardio - Pericardial Diseases > Flashcards

Flashcards in Cardio - Pericardial Diseases Deck (41)
Loading flashcards...
1
Q

What are some congenital pericardial diseases?

A

Absence of pericardium, PPDH

2
Q

What are some acquired pericardial diseases?

A

Pericardial eff and cardiac tamponade, constrictive pericarditis

3
Q

What are the 2 layers of the pericardium?

A

Fibrous and serous (parietal and visceral)

4
Q

What are the 3 types of effusions and which is most common?

A

Hemorrhagic (most common), transudate, exudate

5
Q

What are some DDx for hemorrhagic pericardial eff?

A

Neoplasia (HSA, chemodectoma, mesothelioma, ectopic thyroid CA, LSA), idiopathic

6
Q

What are some DDx for transudate pericardial eff?

A

R-CHF, hypoAlb, chemodectoma, infections/toxemia, pericardial cysts, PPDH

7
Q

What are some DDx for exudative pericardial eff?

A

Infectious (FB/hardware diz in cattle, fungal, bacterial, viral), sterile

8
Q

What are the most common spp to have pericardial effusion?

A

Dogs and cattle

9
Q

Pericardial effusion is a _____ dysfunction disease.

A

diastolic

10
Q

What is cardiac tamponade?

A

Clinical syndrome that occurs when increased intrapericardial pressure interferes with normal cardiac filling

11
Q

What is the pathophysiology of cardiac tamponade?

A
  1. Underlying disease causes pericardial effusion
  2. Increased pressure in pericardial space compresses the heart chambers (R > L)
  3. Reduced cardiac filling –> low CO and low BP
  4. Compensation over time –> sudden death

OR just #3 –> sudden death

12
Q

When does sudden death due to cardiac tamponade occur?

A

If the CO is severely and/or acutely compromised

13
Q

How does compensation work in cardiac tamponade?

A

Over time activation of RAAS results in fluid retention and vasoconstriction, stabilizing the BP

14
Q

What is the appearance of the heart on rads when there is pericadial effusion?

A

Globoid

15
Q

Cardiac tamponade can occur with low volume effusions if they occur _____.

A

rapidly

16
Q

Why does slowly developing pericardial effusion have less consequences over time?

A

The pericardium has time to stretch and the heart can compensate

17
Q

What are some CS of cardiac tamponade?

A

Collapse, weakness, decreased appetite, vomiting, lethargy, decreased milk production (cattle), polyurea, polydypsia

18
Q

PE findings in cardiac tamponade are directly linked to the _____.

A

pathophysiology

19
Q

What are PE findings with cardiac tamponade?

A

Muffled heart sounds, weak pulses (pulsus paradoxus), jugular distention, signs of R-HF

20
Q

What is pulsus paradoxus?

A

Pericardial effusion –> RV free wall can’t stretch –> IVS must stretch further –> decreased LV size –> less LV filling during inspiration –> less blood pumped out to body –> weak femoral pulses during inspiration

21
Q

What are the 3 hallmark findings of pericardial effusion on rads?

A
  1. Enlarged, rounded cardiac silhouette
  2. Dilated CdVC
  3. Small pulmonary arteries and veins
22
Q

What are “other” findings that can show with pericardial effusion?

A

Sharp, well-demarcated edges of cardiac silhouette (less motion artifact), no distinct chamber enlargement, mass effect or lung metastasis, pleural effusion (R-HF), metallic FB (cattle)

23
Q

What ECG abnormalities may be observed in pericardial effusion?

A

Decreased QRS amplitude (< 1 mV), electrical alternans (heart “swings” in the fluid)

24
Q

What is electrical alternans?

A

ECG finding where the R waves are of variable heights due to large effusions where the heart “swings” in the fluid

25
Q

What does pericardial effusion look like on echo?

A

Anechoic (black) fluid between pericardium and heart (mixed echogenicity if exufate or new blood)

26
Q

What finding can cardiac tamponade cause on echo?

A

Compression/collapse of RA +/- RV

27
Q

What is the treatment for pericardial effusion if the patient is unstable / low BP?

A

IVF while preparing for a pericardiocentesis (shock bolus of crystalloids), reassess BP, repeat until ready

28
Q

What are potential complications of a pericardiocentesis?

A

Infection, arrhythmias, hemorrhage, pneumothorax, cardiocentesis

29
Q

How can infection be avoided in a pericardiocentesis?

A

sterile technique

30
Q

How can arrhythmias be noted during a pericardiocentesis?

A

monitor ECG

31
Q

How can hemorrhage be avoided in a pericardiocentesis?

A

tap the R side

32
Q

How can a pneumothorax be avoided in a pericardiocentesis?

A

tap on R side

33
Q

How can you tell you have pericardial fluid and that you didn’t accidentally do a cardiocentesis?

A

Pericardial effusion does not clot (heart blood does)

34
Q

What phrase is helpful to remember the technique for a pericardiocentesis?

A

Go RIGHT, AHEAD, and TAP

R side of chest, cranial to the rib, perform tap

35
Q

What can constrictive pericarditis be likened to?

A

Shrink wrapping the heart

36
Q

What is the pathophysiology of constrictive pericarditis?

A

Inflammatory or infectious process –> thickened, noncompliant pericardium +/- adhesion to epicardium prevents relaxation of the heart –> reduced filling –> low CO and low BP –> same CS, etc. as effusion except heart can be normal size

37
Q

T/F: Absence of the pericardium is not clinically significant

A

True

38
Q

What is PPDH?

A

Pericardioperitoneal diaphragmatic hernia:

abnormal connection from the abdomen to the pericardium

39
Q

What is the signalment for PPDH?

A

Cats > dogs (weimeraners)

40
Q

What CS are associated with PPDH?

A

Vary depending on organs affected; tachypnea, dyspnea, vomiting, anorexia, weight loss

41
Q

When should a PPDH be repaired?

A

If it causes symptoms or has bowel entrapment

Decks in Small Animal Medicine Class (100):