Term
| What is the membrane that covers the heart? |
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Definition
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Term
Name the layers of the Pericardium |
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Definition
-Parietal Pericardium(outer layer) -Visceral Pericardium(inner layer) |
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Term
| What is the space within the Pericardium Layers called? |
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Definition
| Pleural space or Pericardial cavity |
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Term
Which part of the heart is not surrounded by the pericardium? |
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Definition
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Term
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Definition
| Inflammation of the pericardium caused by infections, trauma, radiation theraphy, uremia, or transmural myocardial infarction |
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Term
| What is Transmural Myocardial Infarction? |
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Definition
| It is an infarction that involves the whole thickening of the heart muscle from endocardium to epicardium |
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Term
| What are the symptoms of Pericarditis? |
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Definition
-Chest pain
-Dry cough
-Fever and chills
-Weakness |
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Term
| What is the triad of Pericarditis? |
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Definition
-Friction Rub & Paradoxical Pulse
-Chest pain
-Electrocardiographic changes |
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Term
| Name the pulse that becomes weaker with inspiration and stronger with expiration |
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Definition
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Term
| What are the echo findings seen with Pericarditis? |
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Definition
-Efussion around the heart(r/o tamponade)
-Pericardial thickening with increased echogenicity (r/o constrictive pericarditis) |
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Term
| Can Pericarditis be diagnosed through echocardiography? |
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Definition
| No, it is diagnosed by biopsy through Catherization |
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Term
How is Pericarditis treated? |
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Definition
| Painkillers and medication for the infection |
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Term
Disease characterized by a fibrotic, often thickened, and adherent pericardium that impairs diasotlic filling of the heart [image] |
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Definition
| Constrictive Pericarditis |
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Term
| What are the causes of Constrictive Pericarditis and which is the most common? |
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Definition
-Idiopathic-the most common -Chronic Pericarditis -Radiation Therapy |
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Term
| What are the signs and symptoms of Constrictive Pericarditis? |
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Definition
-Dyspnea -Kussmaul's sign increasing with inspiration -Ascites -Edema -Pericardial knok heard during diastole |
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Term
| The increase in venous distention and pressure occuring during inspiration is a sign of Constrictive Pericarditis and it is called: |
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Definition
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Term
| What are the 2D echo findings seen with Constrictive Pericarditis? |
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Definition
-Normal systolic LV function
-Thickened pericardium
-Flat posterior wall motion in diastole
-Septal motion bounce
-Biatrial enlargement
-Dilate IVC
-Premature opening of Pulmonic valve |
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Term
| What are the M-Mode findings seen with Constrictive Pericarditis? |
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Definition
-Rapid and early closure of MV -Exagerated ant. motion of septum with atrial filling -Double bouncing of septum during atrial systole -Premature opening of pulmonic valve -Pericardial thickening |
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Term
What are the Doppler findings seen with Constrictive Pericarditis? |
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Definition
-Present MR and TR
-Stage 3 Diast. Dysfunction
-Respiratory changes>>25% in LVIT
>35% in RVIT |
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Term
What are the steps and the formula used to assess Constrictive Pericarditis? |
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Definition
1. Lower the sweep speed to 25
2.Measure the shortest E wave from inspiration
3.Measure the tallest E wave from expiration
4. Apply formula:
shortest insp / highest exp x 100 |
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Term
| What must be done to rule out Constrictive Pericarditis when respiratory changes are noted on doppler? |
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Definition
| Catheterization must be done on the patient to look for "Dip and Plateau" sign so we can rule out Constrictive Pericarditis |
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Term
How is Constrictive Pericarditis treated? |
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Definition
| Pericardiectomy, which is stripping of the pericardium |
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Term
| Name the disease that has abnormal accumulation of fluid within the pericardial space |
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Definition
[image]Pericardial effusion |
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Term
| Name the anterior only echo-free space that may be misplaced as a pericardial effussion |
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Definition
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Term
| Name the rare effusion that may follow post-op cardiac surgery or may be seen with metastatic diseases |
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Definition
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Term
| What are the causes of Pericardial effusion and which is the most common? |
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Definition
-Idiopathic-the most common -Viral, bacterial or fungal infections -Tuberculosis -Uremia -Radiation -Myocardial infarction -Post cardiac surgery |
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Term
| What are the signs and symptoms of Pericardial effusion? |
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Definition
-chest pain -dyspnea -friction rub -pulsus paradoxus -distended neck veins |
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Term
| What does Pulsus Paradoxus provoke when Pericardial effusion is present? |
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Definition
| Decrease > 10mmHg in systolic blood pressure during inspiration creates Pulsus Paradoxus |
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Term
What are the 2D and M-Mode findings of Pericardial Effusion? |
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Definition
-Free space between visceral and parietal pericardium
-Loculated effusions due to post-op surgery
-Fibrin strands seen with long standing effusions
-Pericardial effusion forms between LA & Desc.Aorta |
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Term
| Which is the best view to look for pericardial effusion? |
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Definition
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Term
| What are the ranges for Pericardial effusion? |
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Definition
-Small: < 0.5 cm & posterior only
-Moderate: 0.5-2cm & surrounds the entire heart
-Large: > 2cm & surrounds the entire heart |
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Term
How is Pericardial Effusion assessed? |
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Definition
Using spectral doppler to check for respiratory variations in flows across the valves:
>25% difference in E wave - LVIT flow
>35% difference in E wave - RVIT flow |
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Term
Mention some false positives for Pericardial Effusion? |
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Definition
-Pleural effusion(posterior to Desc. AO)
-Epicardial fat pad
-Hiatal hernia
-Desc. Aortic Aneurysm
-Massive LAE
-LV Pseudoaneurysnm |
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Term
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Definition
| Rapid accumulation of fluid within the pericardial space that causes the pressures in the pericardium to exceed the pressures in the chambers resulting in impaired cardiac filling |
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Term
| What is the most common cause of Tamponade? |
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Definition
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Term
| In what part of cardiac cycle does Tamponade push against the heart? |
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Definition
| During diastole inhibiting the filling |
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Term
| What causes Pulsus Paradoxus when Tamponade is present? |
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Definition
| Inspiratory drop of B/P more than 10mmHg |
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Term
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Definition
| -Elevated venous pressure -Hypotension -Quiet heart sound |
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Term
Name the best method to use when assessing for Tamponade? |
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Definition
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Term
| What changes will be seen with hepatic vein flow when Cardiac Tamponade is present? |
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Definition
| Reversal of S and D waves during expiration with prominent R wave |
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Term
| What changes will be seen with pulmonary vein flow when Cardiac Tamponade is present? |
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Definition
| Increase in S wave of > 25% with expiration and decrease with inspiration |
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Term
| What can cause false positive for respiratory variation seen with Tamponade? |
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Definition
-Unstable sample vol. -COPD -Pleural effusion |
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Term
| Name the invasive procedure in which the physician removes fluid from the pericardial sac |
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Definition
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Term
| List some of the risks associated with Pericardiocentesis |
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Definition
-Puncture of the myocardium
-Pneumopericardium(allowing air into pericardial sac)-Myocardial Infarction
-Induced Arrhythmias
-Infections
-Puncture of the lung, liver, or stomach |
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Term
How is the surgical drainage procedure named, when an opening in the pericardial sac is created allowing the fluid to drain into the chest cavity |
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Definition
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