Studied by 14 people
Pericarditis can occur s/p viral URI caused by what virus?
Coxsackie
Where does pericarditis pain radiate?
Back, shoulder, neck, epigastrium
What position relieves pain in patients with pericarditis?
Leaning forward/sitting up
What is heard upon auscultation of patients with pericarditis?
Pericardial friction rub that is "scratchy" over LSB
Pericardial friction rub is heard best when the patient is in what position?
Leaning forward during expiration
What is the most important physical finding of pericarditis?
Scratchy friction rub
What CXR findings may be seen in patients with pericarditis?
Increased cardiac silhouette w/ "H2O bottle" configuration
What would pericarditis or pericardial effusion show on a CXR?
Increased cardiac silhouette w/ "H2O bottle" configuration
What are diffuse concave ST-elevation in all leads, or T-wave inversion and possible PR depression indicative of?
Pericarditis
In pericarditis, what test may be normal w/ minimal fluid noted?
Echo
What test can aid in diagnosis of pericarditis, as fluid is not likely to yield helpful info?
Pericardial biopsy
What medication is used to treat recurrent pericarditis?
Colchicine
What medications are used to treat pericarditis?
NSAIDs (+Abx if bacterial)
What does the fluid accumulates in pericardial effusion create which in turn causes sx?
Pressure
In pericardial effusion, symptoms depend on the size of the effusion and what else?
how fast it develops
Pericardial effusion may have symptoms due to pressure of adjacent structures, such as the __________ & __________
Esophagus & Trachea
What EKG findings may be seen with tamponade?
Electrical alternans
What can be heard upon auscultation of patient with pericardial effusion?
Muffled heart sounds
What is the most useful test for pericardial effusion?
Echo
What can be determined regarding pericardial effusion on echo?
Size of effusion, Location of effusion, Hemodynamic significance
What can collapse on inspiration in pericardial effusion?
RV
How is pericardial effusion treated?
Pericardiocentesis or Pericardial window (drainage)
What is Beck's triad?
JVD, Hypotension, Muffled heart sounds
Which pulse can be associated with cardiac tamponade?
Pulsus paradoxus
What is Beck’s triad associated with?
Cardiac tamponade
Patient presents with JVD, hypotension, and muffled heart sounds. What is this indicative of?
Cardiac tamponade
What is Kussmaul sign?
Paradoxical increase in venous distention and pressure during inspiration
Kussmaul sign may be seen in what condition?
Cardiac tamponade
How is cardiac tamponade treated?
Pericardiocentesis or Pericardial window (drainage)
What is it when fibrotic thickening of the pericardium that adheres to the heart?
Constrictive pericarditis
What do sx of mild-moderate constrictive pericarditis mimic?
Right HF
What are some symptoms seen in mild-moderate constrictive pericarditis?
Leg edema, Abdominal fullness, Pain from hepatic congestion (similar to R HF)
What are some symptoms seen in severe constrictive pericarditis?
Pulmonary congestion (cough, DOE, orthopnea), Fatigue, Decreased CO
What finding can be seen on CXR in patients with constrictive pericarditis?
Calcification ring
What does constrictive pericarditis show on a CXR?
Calcification ring
T/F: Pulsus paradoxus is usually seen in constrictive pericarditis
False- usually absent
In constrictive pericarditis, an echo may show what?
Thickened pericardium w/ no effusion
What is the treatment for constrictive pericarditis?
Salt restriction, Diuretics, Pericardectomy
What tx can be performed to treat constrictive pericarditis, but has high operative mortality?
Pericardectomy
What can the latent period of Chaga's disease cause?
Myocarditis
What are some drugs that can cause drug-induced myocarditis?
Chemo drugs- Doxorubicin, 5-FU
HIV drugs- Zidovudine
Phenytoin
2/3 of myocarditis patients have what kind of symptoms?
Flu-like
How do most cases of myocarditis present?
Clinically silent
What is the treatment for peripartum myocarditis?
IVIG, Hydralazine & NTG (if CHF symptoms), Anticoagulation (if thrombus involved)
What are some lab findings associated with myocarditis?
Increased WBC & ESR, Elevated cardiac enzymes, Elevated immunoglobulins, Abnormal T & B cell counts, Cardiac-specific antibodies
What can present with 4-fold increase in immunoglobulins & cardiac-specific antibodies in blood?
Myocarditis
In myocarditis, CO is ______________
Decreased
In myocarditis, LVEDP is ____________
Elevated
What may end up being the best confirmatory test for myocarditis if EBM cannot be performed?
MRI
What is the definitive test for myocarditis?
Biopsy
What should pts avoid while inflammation is present in myocarditis?
Exercise
What is the most common cause of cardiac tamponade?
Malignant pericarditis
Note 
Flashcard (254)