This document discusses pericarditis, which is inflammation of the pericardium. It describes the different types of pericarditis and various etiologies in cattle, horses, small animals, sheep, goats and pigs. Clinical findings include lethargy, respiratory difficulty and muffled heart sounds. Diagnosis involves thoracic radiography, echocardiography and electrocardiography. Treatment depends on the underlying cause but may include pericardiocentesis, antibiotics, drainage or pericardiectomy. Pericardiocentesis provides immediate relief for cardiac tamponade and allows diagnostic sampling. Prognosis varies based on the causative agent but is generally poor for septic pericard

1. Dr. V.K.Gupta
Senior Scientist,
Medicine Division
I.V.R.I.IZATNAGAR(UP)

2.  Heart

4. Pericarditis
 Effusive
 Fibrinous
 Constrictive

5. Etiology
 Cattle
 Mannheimia hemolytica
Black disease -if patients survive more than 24 hours
 Sporadic bovine encephalomyelitis
Haemophilus spp., including Histophilus somni
 Tuberculosis
 Pseudomonas aeruginosa
 Mycoplasma spp.
 Klebsiella pneumoniae
 Actinobacillus suis
 Idiopathic effusive (nonseptic) pericarditis

6.  Traumatic pericarditis
 Development of toxemia and congestive heart failure

7.  Horses
 Streptococcus spp.- S. equi, S. zooepidemicus and
S. faecalis
 Tuberculosis
 Corynebacterium pseudotuberculosis
 Actinobacillus equuli
 EHV-1 infection
 Idiopathic effusive

8. Small animals
 Congenital pericardial disorder
Peritoneopericardial diaphragmatic hernia
b/w 4wks & 15 yrs , majority first 4yrs life
Male > female
 Acquired
Bacterial
Fungal – Coccidioidesimmitis
Aspergillusniger
Viral – feline infectious peritonitis
Protozoal – visceral leishmaniasis
Idiopathic – 19-23 %

9.  Metabolic and/or toxic form
Uremia
Coagulation disorder
 anticoagulant rodent toxicity
Secondary to DIC
Warfarin toxicity
Coagulopathies
 Cardiovascular disorder
CHF
Left atrial perforation
Mitral regurgitation in deg. Valvular disease

10.  Neoplasia
Cardiac hemangiosarcoma – in right. atrium mostly
61% cause of effus. Pericarditis
Heart base tumor
Associated with ascending artery and main pulmonary
artery
Aortic body tumor
Ectopic thyroid tumor
Breed predis.- english bulldog, boxer, boston terrier ,
In chronic hypoxia induced hyperplasia and neoplasia
of chemoreceptors

11.  Mesothelioma
 diffuse neoplasm of the pericardium and other serosal
surfaces
 Lymphosarcoma
 Rhabdomysarcoma
 Fibrosarcoma

12.  Sheep and goats
Pasteurellosis
Staphylococcus aureus
Mycoplasma spp.
 Pigs
 Pasteurellosis
Mycoplasma hyorhinis
 Haemophilus spp. - Glasser's disease and
pleuropneumonia
Streptococcus spp.
 Salmonellosis

13. Pathogenesis
 In the early stages
Inflammation Hyperemia Deposition of
Fibrinous Exudate Friction Sound Muffling of
The Heart Sounds Atria and Right Ventricle
Compression CHF
Toxemia
Anaerobic bacteria gas-production washing
machine sound of fluid splashing with each heart beat

14.  In the recovery stag
 Reabsorption of fluid adhesive pericarditis
 In suppurative pericarditis complete adhesion

15. CLINICAL FINDINGS

16. Clinical signs
 Lethargy
 Resp. difficulty
 Collapse
 Reduced appetite
 Vomiting
 Abd. Distension
 Polydipsia
 Weakness
 Coughing

17. Pulsus paradoxus
 Associated with cardiac tamponade
 Phasic variation in pulse quality with respiration
 ≥10 mm Hg decrease in systolic arterial BP with
inspiration during normal breathing
 LV stroke volume and systemic arterial BP decreases
with inspiration

18. Diagnosis
 Thoracic radiograph

19.  Echocardiography

20.  Echo

21. Echocardiograph

22.  Hemangiosarcoma

23. Electrocardiography
 Electrical alternans is evident on this lead II
electrocardiogram from a 10-year-old male Bulldog with a
large pericardial effusion. Note also the small voltage QRS
complexes
 Sinus Tachycardia (heart rate about 170 beats/min)

24. Hematology and biochemistry
 Hemangiosarcoma
Anemia , nucleated RBC .,
Schistocyte , acanthocyte &
thrombocytopenia
Increased serum cardio tropin I
 Increased liver enzyme
 Mild prerenal azotemia
 In FIP – neutrophilia , lymphocytopenia ,
hyperglobulinemia
 Ascites fluid- protein transudate

25. Diff. diagnosis
 Other cause of Rt. CHF – DCM, tricuspid dysplasia ,
ascites( hepatic disease , Abd. Neoplasia)
 Other cause of muffled heart sound- pleural effusion,
thoracic mass , diaphragmatic hernia
 Other cuase of low voltage complexe- pleural effusion,
obesity, hypothyroidism
 Other cause of cardiac enlargement – DCM, tricuspid
dysplasia, PPDH

26. Treatment & prognosis
 Important to differentiate cardiac tamponade from
other causes of right-sided CHF because the treatment
is very different.
 Positive inotropic drugs do not ameliorate the signs of
tamponade; diuretics and vasodilators can further
reduce cardiac output and exacerbate hypotension and
shock
 Pericardiocentesis is the immediate treatment of
choice, and it also provides diagnostic information
 Most signs of CHF resolve after pericardial fluid is
removed

27.  Pericardial effusions secondary to other diseases that
cause CHF, congenital malformations, or
hypoalbuminemia do not usually cause tamponade
and often resolve with management of the underlying
condition.
 Antibacterial treatment of the specific infection
should be undertaken if possible on the basis of
susceptibility on organisms cultured from the
pericardial fluid
 The prognosis varies with the etiological agent but it is
generally grave in cases of septic pericarditis

28.  Fifth rib resection and pericardial marsupialization
 Pericardial drainage and intrapericardial lavage
 Antimicrobial administration
 Recurrent effusion that does not respond to repeated
pericardiocentesis and anti inflammatory therapy is
usually treated by subtotal pericardiectomy.
 Removal of the pericardium ventral to the phrenic
nerves allows pericardial fluid drainage to the larger
absorptive surface of the pleural space
 Neoplastic pericardial effusions are also drained to
relieve cardiac tamponade

29.  Surgical therapy is likely to be more effective than
continuous drainage with an indwelling pericardial
catheter, and it also allows removal of penetrating
foreign bodies

30. PERICARDIOCENTESIS
 Done immediately in animals with cardiac tamponade.
 diuretics or vasodilators without pericardiocentesis
may cause further hypotension and cardiogenic shock.
 Pericardiocentesis should be performed under
ultrasonographic guidance and with ECG monitoring.