pericardial disease

Pericardium on US

Bright white line

Purpsoe of pericardium (not vital organ)

Prevent over dilation

Dec friction

Coordinate LV RV interaction

Protection

Position

Congenital pericardial diseases

PPDH, pericardial cysts, pericardial defect/absence

Type of pericardial effusion in dogs

Haemorrhagic

Causes of pericardial effusion

Idiopathic

Neoplasia

CHF (L in cats)

Coagulopathy

Hypoproteinaemia

PPDH

FIP, inf

FB

Renal failure

Main Causes of pericardial effusion In dogs (commonly old, large)

Idiopathic

Neoplasia

Main Causes of pericardial effusion In cats

CHF

FIP

Inf

Lymphoma, mesothelioma, rhabdomyosarcoma

coagulation

uraemia

Pericardial effusion in dogs - idiopathic Dx

Exclusion Dx (US, cytology)

Pericardial effusion in dogs - idiopathic Cause

Fibrosis, infl

Pericardial effusion in dogs - idiopathic Breeds

St Bernard, retriever, lab

Pericardial effusion in dogs - idiopathic When to perform pericardectomy

Drain x 3 + recur

Pericardial effusion in dogs - haemangiosarcoma breeds

German shepherd, retriever, setter

Pericardial effusion in dogs - haemangiosarcoma Location

RA, spleen, liver

Pericardial effusion in dogs - haemangiosarcoma Presentation

H shock

Acute

Pericardial effusion in dogs - haemangiosarcoma Tx (6mon prognosis)

Palliative

Pericardiocentesis

Chemo

Pericardial effusion in dogs - chemodectoma location

Heart base (aortic arch + pul a)

Pericardial effusion in dogs - chemodectoma Breeds

Brachys

Pericardial effusion in dogs - chemodectoma Prognosis

Benign + slow growing

Pericardial effusion in dogs - chemodectoma Tx

Pericardectomy

Pericardial effusion in dogs - mesothelioma breeds

None

Pericardial effusion in dogs - mesothelioma effect

Multiple cavity effusions

Pericardial effusion in dogs - mesothelioma Tx (hard to Dx)

Palliative

Chemo

Effect of pericardial effusion -

Squashed RA → Dec RV filling

→ dec SV → dec LV filling → dec LV SV

→ dec v return → R CHF

→ V interdependence of LV in insp → pulseless paradox

Effect of pericardial effusion - Cardiac tamponade

Intra pericardial P > RA P → RA collapse in diastole → RCHF

Pericardial effusion in dogs - CS

AL, leth, GI upset

Abd enlargment (ascites), dec exercise tolerance, cough, syncope

Pericardial effusion in dogs - chronic RCHF CS

Organomegaly, abd effusion, + hepatojug reflux, jug pulse, tachycardia

Weak femoral pulse, pulsus paradoxus

Muffled heart sounds

Pericardial effusion in dogs - Acute CS

Weak, collapsed, tachycardia, pale mm, arrhythmia, H shock, weak pulses

Pericardial effusion in dogs - Dx before centesis

PCV, haem, biochem, CTnl

Pericardial effusion in dogs - Dx

PCV, haem, biochem, CTnl

Coag, BP, ECG, US (echo+abd), Rx, fluid analysis

Pericardial effusion in dogs - ECG shows +why

QRS height changes - moving heart

Small QRS = squashed heart

Sinus tachycardia

Pericardial effusion in dogs - X-ray

Enlarged football heart

CHF = v distension

Pericardial effusion in dogs - US

Fluid around heart

Squashed RV

Pericardial effusion in dogs - Which drug to not use + why

Furosemide as no CHF and reduces blood volume

Pericardial effusion in dogs - Tx

No diuretics

Pericardiocentesis - opioid sedation, L lat recumbency, 5-6 ICS, lidocaine, 3 way tap

Pericardial effusion in dogs - Pericardiocentesis location

5-6 ICS

Pericardial effusion in dogs - How to tell not blood in centesis

Improve CS

Doesn’t clot

ECG change

PCV repeated + should be different

Pericardial effusion in dogs - Fluid analysis after centesis tube types

EDTA tube for PCV, Cytology

Plain for coagulation

Pericardial effusion in dogs - Aftercare for centesis

Diuresis from ascites + natriuretic peptides

Hospitalise in case of A fib, V arrhythmias, weighing

Pericardial effusion in dogs - What does it mean if recurs/ no improvement after centesis

Neoplasia = poor prognosis

Constrictive pericarditis - gross

Thick fibrotic pericardium

Constrictive pericarditis - Tx

Pericardectomy, pericardial stripping

Peritoneal pericardial diaphragmatic hernia - breeds

Weimaraners, Persians

LA rupture - tx

Pericardiocentesis, transfusion, thoracotomy

Inf pericarditis - causes

FB, wound, inf, FIP

Worst pericardial disease prognosis

Haemangiosarcoma