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Flashcards in Pericardial Disease Deck (48)
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1
Q

Mono layer of mesothelioma cells and collagen and elastin fibers adherent to the pericardial surface of the heart

A

Visceral pericardium

2
Q

2mm thick, and largely acellular and contains collagen and elastin fibers

A

Fibrous parietal pericardium

3
Q

Fixes the heart within the mediastinum and limits its motion

A

Pericardium

4
Q

Pericardial inflammation of no more than 1 to 2 weeks duration that can occur in a variety of diseases but most cases are considered idiopathic

A

Acute pericarditis

5
Q

Most idiopathic pericarditis cases are presumed to be

A

Viral

6
Q

What are the 4 clinical features of acute pericarditis?

A

Pleuritic chest pain, pericardial friction rub, fever, and ECG abnormalities

7
Q

Relieved by sitting forward and worsened by lying down

A

Pleuritic chest pain

8
Q

Made up of three components, ventricular systole, early diastolic filling, and atrial contraction

A

Pericardial friction rub

9
Q

How do we treat relapsing and recurrent pericarditis?

A

NSAIDs, colchicine, and prednisone

10
Q

Up to 60% of infectious etiologies of pericarditis cause a late scarring complication called

-Uncommon after viral pericarditis

A

Constrictive pericarditis

11
Q

Most cases of pericarditis respond to treatment with an

A

NSAID and Colchicine

12
Q

Should be avoided in treating pericarditis

A

Glucocorticoids

13
Q

Idiopathic pericarditis or any infection, neoplasm, autoimmune, or inflammatory process that can cause pericarditis can also cause a

A

Pericardial effusion

14
Q

Collection of fluid between visceral and parietal pericardium

A

Pericardial effusion

15
Q

Soft heart sounds and reduced intensity of pericardial friction rub are the clinical features of

A

Pericardial Effusion

16
Q

Dullness over posterior left lung that is indicative of pericardial effusion

A

Edward sign

17
Q

An ECG characteristic of pericardial effusion is

A

Electrical alternans (an alternating between QRS amplitudes)

18
Q

When fluid accumulates in the pericardial space under high pressure, compresses the cardiac chambers, and comprises cardiac output

A

Cardiac Tamponade

19
Q

The primary effect of high pericardial pressure in cardiac tamponade is to impede filling of the

A

Right side of the heart

20
Q

Characterized by elevated and equal interactivity pressures w/ low transmural filling pressures and low cardiac volumes

A

Cardiac Tamponade

21
Q

Shows loss of the Y descent of right atrial or systemic venous pressure wave

A

Cardiac tamponade

22
Q

Pulses paradoxus is indicative of

A

Cardiac Tamponade

23
Q

Normally begins when the tricuspid valve opens, i.e. when blood is not leaving the heart

A

Y descent

24
Q

In cardiac tamponade, blood can only enter the heart when blood is also simultaneously

A

Leaving

25
Q

Therefore, in tamponade, inflow can not increase until blood is also leaving so we lose

A

Y descent

26
Q

Occurs during ventricular ejection

A

X descent

27
Q

Thus, in tamponade, because blood is leaving the heart, inflow can increase and thus

A

X is maintained

28
Q

The phenomenon of systolic BP declining slightly following inspiration

A

Pulsus Parodoxus

29
Q

In cardiac tamponade, both ventricles share a fixed volume due to the external compression by the tense pericardial fluid. This we see an exaggeration of

A

Pulsus Paradoxus

30
Q

Can be caused by pericarditis or acute hemorrhage into the pericardium

A

Cardiac Tamponade

31
Q

What are the two major features of cardiac tamponade

A

Beck’s triad and pulsus paradoxus

32
Q

What is Beck’s triad?

A

Hypotension, muffled heart sounds, and elevated JVP

33
Q

To treat cardiac tamponade, we want to perform and urgent or emergency closed

A

Pericardiocentesis

34
Q

Until pericardiocentesis can be performed, we want to give IV saline and

A

Isoproterenol

35
Q

The end stage of an inflammatory process involving the pericardium, resulting in dense fibrosis, calcification, and adhesion of parietal and visceral pericardium

A

Constrictive pericarditis

36
Q

The pathophysiological consequence of constrictive pericarditis is markedly restricted

A

Filling of Heart

37
Q

In constrictive pericarditis, almost all filling occurs early in

A

Diastole

38
Q

Results in systemic venous congestion which results in hepatic congestion’s, peripheral edema, ascites, anasarca, and cardiac cirrhosis

A

Constrictive pericarditis

39
Q

Failure of transmission of changes in intrathoracic pressure to the cardiac chambers is an important contributor to the pathophysiology of

A

Constrictive Pericarditis

40
Q

W/ constrictive pericarditis, the decrease in intrathoracic pressure on inspiration is transmitted to the pulmonary veins but not to the

A

Left side of the heart

41
Q

In constrictive pericarditis, the high systemic pressures and reduced cardiac output result in the kidneys retaining

A

Sodium and water

42
Q

Characterized by reduced CO, elevated systemic venous pressures, pericardial knock, and Kussmaul sign

A

Constrictive pericarditis

43
Q

An early diastolic sound heard best at the LLSB and or cardiac apex

A

Pericardial knock

44
Q

Inspiration increase in venous pressure

A

Kussmaul sign

45
Q

When differentiating between constrictive pericarditis and cardiac tamponade, what is highly indicative of cardiac tamponade?

A

Pulsus Paradoxus

46
Q

When differentiating between constrictive pericarditis and cardiac tamponade, what is highly indicative of constrictive pericarditis?

A

Kussmaul sign

47
Q

In JVP recordings, the

  1. ) y descent is lost in?
  2. ) y descent is normal in?
A
  1. ) Tamponade

2. ) Constrictive pericarditis

48
Q

We also must differentiate between constrictive pericarditis and

A

Restrictive cardiomyopathy (e.g. amyloid)