Pericardial Effusion and Constrictive Pericarditis
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Questions and Answers

What is the function of the pericardium?

  • To reduce contact between the heart and the surrounding structures (correct)
  • To pump blood to the surrounding structures
  • To cause an increase in intrapericardial pressure
  • To stretch rapidly to accommodate fluid accumulation
  • What is acute pericarditis characterized by?

  • Thickened, rigid, and fibrous pericardium
  • Symptom-free interval of > 4-6 weeks
  • Inflammation of the inner visceral layer of the pericardium
  • Inflammation of the pericardium lasting < 3 months (correct)
  • What is cardiac tamponade associated with?

  • Chronic pericarditis
  • Pericarditis
  • Pericardial effusion (correct)
  • Constrictive pericarditis
  • What is the most common etiology of infectious pericarditis?

    <p>Coxsackie B virus</p> Signup and view all the answers

    What characterizes constrictive pericarditis?

    <p>Thickened, rigid, and fibrous pericardium secondary to acute pericarditis</p> Signup and view all the answers

    What is the condition called when there is a recurrence of pericarditis after a symptom-free interval?

    <p>Recurrent pericarditis</p> Signup and view all the answers

    The radiographic sign of a large pericardial effusion in which the cardiac silhouette resembles a bottle is known as:

    <p>Water bottle sign</p> Signup and view all the answers

    Which imaging modality is the most accurate technique to image calcified tissue in the context of constrictive pericarditis?

    <p>Cardiac MRI</p> Signup and view all the answers

    In the context of constrictive pericarditis, what is the main differential diagnosis for which BNP levels can be used to differentiate?

    <p>Restrictive cardiomyopathy</p> Signup and view all the answers

    What is the recommended diagnostic tool for detecting pericardial effusions and pericardial tamponade due to its quick and safe nature?

    <p>Echocardiography</p> Signup and view all the answers

    Which condition may show associated myocarditis on cardiac MRI in the context of constrictive pericarditis?

    <p>Pericardial effusion</p> Signup and view all the answers

    What is the primary differential diagnosis for constrictive pericarditis when the diagnosis is not clear after non-invasive tests, as indicated by similar pressures in the left and right atria and right ventricle at the end of diastole?

    <p>Restrictive cardiomyopathy</p> Signup and view all the answers

    Which anatomical detail of the heart and pericardium can be assessed using CT scan with IV contrast in the context of constrictive pericarditis?

    <p>Pericardial thickening</p> Signup and view all the answers

    Which blood markers are commonly elevated in patients with acute pericarditis, indicating an elevation of inflammatory markers?

    <p>ESR, CRP, CBC</p> Signup and view all the answers

    Which chamber collapse during systole is an early sign of cardiac tamponade?

    <p>Collapse of the right atrium</p> Signup and view all the answers

    What is the characteristic imaging tool used for diagnosing constrictive pericarditis based on characteristic imaging findings?

    <p>Echocardiography</p> Signup and view all the answers

    In patients with acute pericarditis, when should aetiological investigations be considered according to the text?

    <p>Mandatory if there is any clinical presentation that may suggest an underlying aetiology</p> Signup and view all the answers

    What does equilibration of average diastolic pressure and characteristic respiratory reciprocation of cardiac pressures indicate in cardiac catheterization?

    <p>Constrictive pericarditis</p> Signup and view all the answers

    What is the significance of a glucose level <60-80 mg/dL in pericardial fluid analysis?

    <p>It suggests a tuberculous cause of effusion</p> Signup and view all the answers

    What does an isolated pericardial fluid LDH elevation of >300 units/dL suggest?

    <p>Malignant effusion</p> Signup and view all the answers

    Which investigation is indicated for suspected uremia as an underlying etiology of pericardial effusion?

    <p>Creatinine, BUN, electrolytes</p> Signup and view all the answers

    In the context of recurrent pericarditis, what does the therapy target?

    <p>Underlying aetiology</p> Signup and view all the answers

    What is the first step when a pericardial effusion is detected?

    <p>Assessment of size</p> Signup and view all the answers

    What is the mainstay of therapy for acute pericarditis?

    <p>Aspirin or NSAIDs</p> Signup and view all the answers

    When should corticosteroids be considered in the treatment of pericarditis?

    <p>In patients with contraindications and failure of aspirin or NSAIDs</p> Signup and view all the answers

    What does cardiac tamponade without inflammatory signs suggest?

    <p>A neoplastic etiological cause</p> Signup and view all the answers

    When is pericardiocentesis alone necessary for the resolution of large effusions?

    <p>When conventional therapy fails to resolve the effusion</p> Signup and view all the answers

    What is the treatment approach for cardiac tamponade in unstable patients?

    <p>Pericardiocentesis without delay</p> Signup and view all the answers

    What is the main mechanism for pericardial effusion that leads to cardiac tamponade?

    <p>Pathological inflammatory process with increased production of pericardial fluid (exudate)</p> Signup and view all the answers

    Which symptom is NOT associated with pericardial effusion?

    <p>Nausea</p> Signup and view all the answers

    What is the term for the inspiratory decrease in systolic blood pressure of more than 10 mmHg during normal breathing?

    <p>Pulsus paradoxus</p> Signup and view all the answers

    Which condition is NOT a common cause of pericardial effusion?

    <p>Heart attack</p> Signup and view all the answers

    What is the term for the high-pitched scratching sound on auscultation that indicates friction between the visceral and parietal pericardial tissue?

    <p>Pericardial rub</p> Signup and view all the answers

    Which chamber of the heart is especially affected by compression in cardiac tamponade?

    <p>Right ventricle</p> Signup and view all the answers

    What is the term for the dullness to percussion at the base of the left lung, increased vocal fremitus and bronchial breathing due to the compression of lung parenchyma by the pericardial effusion?

    <p>Ewart sign</p> Signup and view all the answers

    Which disease is NOT associated with autoimmune connective tissue diseases as a cause of pericarditis?

    <p>Multiple sclerosis</p> Signup and view all the answers

    What is the term for the life-threatening complication in pericardial effusion due to compression of the heart by pericardial accumulation of fluid, pus, blood, or clots?

    <p>Cardiac tamponade</p> Signup and view all the answers

    Which symptom is NOT commonly seen in patients without hemodynamic compromise due to pericardial effusion?

    <p>Dysphagia</p> Signup and view all the answers

    What is the primary clinical sign associated with acute pericarditis?

    <p>Pleuritic chest pain</p> Signup and view all the answers

    What is the main etiology of acute pericarditis?

    <p>Fungal infections</p> Signup and view all the answers

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