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Pericarditis
This is a mind map about pericarditis, which mainly includes: constrictive pericarditis, pericardial effusion and pericardial tamponade, acute pericarditis, and general. The summary is comprehensive and meticulous, suitable as review materials.
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Pericarditis
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- Outline
Pericarditis
General
Anatomy
A heart bag
Wall layer
Dirty layer
Pericardial cavity
15-50ml liquid
Lubrication effect
Function
fixed
barrier
Protect
Prevent excessive heart swelling
Classification
time
Acute pericarditis
＜6w
Subacute pericarditis
6w-March
Chronic pericarditis
＞March
Causes
Infectious pericarditis
Non-infectious pericarditis
Post-Mystolic Syndrome
Immune & Allergic
Acute pericarditis
Causes
Viral infection (most common), tuberculosis infection, post-Mystomia...
pathology
Fibrin → Exudability (fluid accumulation) → Constriction change
Shows & Signs
Early
Cellulosic pericarditis (villi heart)
Performance
The most important manifestation
Chest pain; tingling/sharp pain; posterior sternum/precenteral area
VS Myocardial infarction dull pain, stuffy pain
Radiate to the upper left limb
Cough, variant position, deep breathing → worsen pain
Signs
Pericardial friction sound/pericardial friction feeling
Intercostal 3-4, left margin of the sternum (cardiac exposure area)
Consistent with heartbeat
Late
Exudative pericarditis (pericardial effusion)
See below
examine
First choice
UCG
Chest film
Adult > 250ml
Children >150ml
Feel less and cannot be seen
The most valuable/most meaningful
Pericardial puncture
ECG
Limb lead low voltage
ST section bow raised back down
Question
Summarize
Myocardial infarction → ST segment arch is raised toward the back
Variants angina pectoris → transient elevation of ST segment
General angina pectoris → ST segment depression
treat
Treatment of primary diseases
Pain relief
NSAIDs
Glucocorticoid
Reduce inflammatory response
Repeated attacks
Pericardial resection
Pericardial puncture fluid
Pericardial effusion and pericardial tamponade
Causes
Tumor, idiopathic, infectious
pathology
Pericardial acute exudate ≥200ml → Compress the heart → Limit ventricular diastolic → Systemic circulation congestion, low blood pressure → Cardiac pressure blockage
Performance
The most important/most outstanding performance
Difficulty in breathing
The blood cannot enter the heart, and it stagnates into the lungs, but not much, most of it is circulating in the body
Signs
The heart boundary expands to both sides
auscultation
The heart sound is far away; the heart sound is weak
It's thousands of miles apart
Ewart sign
There is a sound in the percussion below the left scapula
Bronchial breathing sounds
Hey, so much water
Beck Triple Trial
Heart tamponade
Jugular vein opening
Arterial pressure
The heart sound is weak and far away
Suction pulse (superior pulse)
Pulse weakened/disappeared when inhaling
Pericardial effusion
It's strange that there is water in the pericardium
VS Asthma also has this sign
High chest pressure when inhaling is not conducive to blood reflux, less blood and weak pulse
examine
First choice
UCG
Chest film
Triangular flask centre
Roasted chicken
ECG
Limb lead low voltage
ST section bow raised back down
Confirmed
Pericardial puncture
treat
Symptom-based treatment
NSAIDs
Glucocorticoid
Heart tamponade
First choice
Pericarpination ≤200ml/time
Constrictive pericarditis
definition
The heart is surrounded by densely thickened fibrosis or calcified pericardial, and ventricular diastolic disorders are often chronic
Causes
Tuberculous
Most common
Nonspecific pericarditis, suppurative pericarditis, traumatic pericarditis
pathology
Ventricular diastolic restriction → Output ↓ → Accelerated heart rate compensation → Jugular vein angrily
Shows & Signs
Performance
It is mainly related to decreased cardiac output and systemic circulation congestion
Palpitations, dyspnea, large liver, abdominal effusion, lower limb edema
Signs
Jugular vein opening
Kussmaul sign
The heart sounds far and light
examine
X-ray
Heart shadow is triangle or spherical
ECG
UCG
Most commonly used
treat
Chronic constrictive pericarditis
First choice
Pericardial resection
Patients with stable condition
Anti-inflammatory treatment for 2-3 months
Tuberculous pericarditis
Anti-tuberculosis treatment, continue to fight tuberculosis for 1 year after surgery