Pericardial effusion | Pericardial Disease ppt

May 25, 2012 | By | Reply More

Pericardial effusion | Pericardial Disease ppt

power point presentation lecture

Pericardial effusion  (may be acute or chronic, Global or localised)

Pericardial effusion

Spectrum of causes of effusion is similar to acute pericarditis
More likely than constriction following MI and cardiac surgery
Can coexist with acute pericarditis and chronic constrictive disease
Major causes are post cardiac surgery and
Neoplastic disease
Gradual accumulation of fluid (chronic) permits progressive stretching of pericardium
Patient may develop a substantial fluid without significant increase in intrapericardial pressure
Rapid accumulation of fluid (acute) leads to critical elevation of intrapericardial pressure
Significantly increased intrapericardial pressure impedes diastolic filling of the ventricles
Therefore in order for the ventricles to fill the end-diastolic pressure must exceed the pericardial pressure
Global effusion – pericardial pressure is equal around heart
Therefore both ventricles have to increase EDP to same amount for ventricles to fill
Normal difference in diastolic pressures between RV and LV is lost
As the pericardial effusion worsens the EDP cannot raise significantly to maintain cardiac output
Investigations and clinical signs
Clinical examination – SOB, orthopnoea, tachycardia (varying degrees)
Auscultation – may have muffled heart sounds
ECG may show low amplitude QRS complexes and alternating axis
CXR – globular appearance to heart and therefore increased cardiothoracic ratio
Echo – size of effusion and haemodynamic effect of it
Cath lab- diastolic equalization of left and right heart pressures
High RA pressures
Depends on the cause and nature
If acute the cause is treated and the patient monitored
If persistent problem or life threatening more dramatic action is called for

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Category: Medical

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