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Medicine Notes Clinical Cardiology Notes

Pericardial Diseases Notes

Updated Pericardial Diseases Notes

Clinical Cardiology Notes

Clinical Cardiology

Approximately 39 pages

This series of notes is on clinical cardiology. These notes were made using a variety of textbooks, notes from tutorials with consultants and knowledge gained on the ward with doctors. These notes helped me a achieve a good grade of 68% in the end of year exams....

The following is a more accessible plain text extract of the PDF sample above, taken from our Clinical Cardiology Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Pericardial Diseases

  • ACUTE PERICARDITIS

    • Inflammation of pericardium

      • Idiopathic

      • Secondary

        • Viral (Coxsackie; Flu; E-B; Mumps; Varicella; HIV)

        • Bacteria (pneumonia; RF; staphs; streps; MAI in HIV)

        • Drugs (procainamide; hydralazine; penicillin; comolyn Na)

        • Others= Uraemia; RA; SLE; Myoedema; Trauma; Surgery; Malignancy

    • Clinical

      • Central chest pain

      • Worse when lying flat and on inspiration; Relieved sitting forward

      • ?Fever

      • Pericardial friction rub may be heard

      • Look for pericardial effusion or cardiac tamponade

    • Tests

      • ECG Concave ST elevation; May be normal

      • Bloods FBC, ESR, U&E, Troponin (may be up); Viral serology; Cultures

      • X-Ray Cardiomegaly (pleural effusion)

    • Treatment

      • Analgesia (ibuprofen 400mg/8h PO)

      • Treat cause

      • Colchicine before steroids if relapse/continuing (15-40% recur)

  • PERICARDIAL EFFUSION

    • Accumulation of fluid in pericardial sac (same causes as pericarditis)

    • Clinical

      • Dyspnoea

      • Raised JVP

      • Bronchial breathing at L base

      • Look for cardiac tamponade signs

    • Diagnosis

      • CXR Enlarged globular heart

      • ECG Low voltage/alternating QRS

      • Echo Echo free zone around heart

    • Management

      • Treat cause

      • Pericardiocentesis (diagnostic or therapeutic)

  • CONSTRICTIVE PERICARDITIS

    • Heart encased in rigid pericardium

    • Clinical features

      • RHF

      • Raised JVP; Kussmaul's sign

      • Soft, diffuse apex beat

      • Quiet heart sounds

      • Diastolic pericardial knock

      • Hepato-splenomegaly; Ascites; Oedema

    • Tests

      • CXR; CT/MRI; Echo Small heart +/- calcification

    • Management

      • Surgical excision

  • CARDIAC TAMPONADE

    • Accumulation of fluid raises intrapericardial pressure= Poor pump function

    • Causes

      • Any pericarditis

      • Aortic dissection

      • Haemodialysis

      • Warfarin

      • Transeptal puncture at cardiac catherisation

      • Post cardiac biopsy

    • Signs

      • Tachy

      • Pulsus paradoxus

      • Increased JVP

      • Kussmaul's sign

      • Muffled S1 and S2

    • Diagnosis

      • Beck's triad Falling BP; Rising JVP; Muffled heart sounds

      • CXR Big...

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