Pericardial diseases (TV4101, Lecture 6 Notes)

List pericardial diseases

- Pericardial effusion, due to haemorrhage, neoplasia, serous, FIP or infection

- Constrictive pericarditis

- Congenital hernias

- Cardiac tamponade (impaired cardiac filling and venous return, right CHF and low cardiac output with poor tissue perfusion)

Discuss the aetiologies of pericardial effusion

Dogs - idiopathic or neoplastic.

Cats - lymphoma, CHF or FIP.

List clinical signs of pericardial effusion

- Low output cardiac signs

- RCHF signs (i.e. ascites and jugular distension)

- Muffled heart sounds

- Pulsus paradoxus

- Hepatojugular reflex

- ECG electrical alternans

- Radiography with globoid heart, ascites and pleural effusion

Discuss echocardiography findings of pericardial effusion

- Anechoic fluid between hyperechoic pericardium and heart wall

- Variable collapse of RA or RV

- Volume doesn't reflect intrapericardial pressure (assess effect on heart)

Describe pericardiocentesis

- Stabilise patient with aseptic prep and local anaeasthesia

- Require large catheter, 3-way tap, tubing and syringe

- Ultrasound guided and ECG desirable

- Perform right-side only

Discuss cardiac tumours

- Poor prognosis

- Diagnose with fluid cytology/culture, echocardiogram, CBC/biochemistry/UA +/- additional imaging

- Haemangiosarcoma, commonly RA, auricle, spleen and lung with dark blood effusion (consider chemotherapy)

- Heart base tumours

- Lymphoma, common in cats