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Pericardial disease

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Pericardial disease

  1. 1. Pericardial disease Pericardial effusion Cardiac tamponade Constrictive pericarditis
  2. 2. Pericardial effusion  Abnormal accumulation of fluid in pericardial cavity (normal- 15-50 ml)  Types & causes-  Transudative- HF, myxedema, nephrotic syndrome  Exudative- TB, viral infection, SLE, post-MI/CABG  Hemorrhagic- trauma, rupture, malignant  s/s- chest pain/pressure, muffled heart sounds  CxR- enlarged ‘water-bottle heart’  ECG- low voltage, atrial arrythmias  Rx- of underlying disease, drain if required
  3. 3. Cardiac tamponade  Sudden or significant fluid accumulation in pericardial cavity  Causes impaired ventricular filling, leading to low stroke volume  Signs- hypotension, raised JVP, muffled heart sounds  ± pulsus paradoxus- drop in systolic BP of >10 mm Hg on inspiration  May present as PEA or shock  Dx- ECG, ECHO  Rx- pericardiocentesis
  4. 4. Constrictive pericarditis  A late sequelae of pericarditis  Commonest cause- TB  Results in impaired ventricular filling  s/s- fatigue, fluid retention, raised JVP, rapid y descent, Kussmaul sign– raised JVP on inspiration  CxR- pericardial calcification  Dx- ECHO/MRI  Rx- diuretics, surgical pericardial stripping

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