Download Free Medical Pericarditis PowerPoint Presentation

Pericarditis PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Pericarditis, which is titled "Pericarditis", to know about pericarditis, an inflammation of pericardial layer of the heart. Pericardial layer covers the heart and protect it from any infection.

Tags : Pericarditis, inflammation, pericardial layer, heart

Published on : Jul 01, 2021 | Views : 3013 | Downloads : 15

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Pericarditis
Slide 2-

Definition: Is inflammation of pericardial layer of the heart. pericardial layer covers the heart and protect it from any infection.
Slide 3-

A. Viral infection: this is the most important cause in infection coxachi A virus. And B commonest one. B3 , B5. ECHO virus, influenza V. hepatitis V. Bacterial infection – Tubercle bacilli Staphylo coccus Strepto coccus Pneumo coccus Causes: I. Infection: is the most important cause:
Slide 4-

Fugal Infection Parasitic Infection Those causes same as the causes of myocordotis and so the patient with acute myocarditis can present with pericarditis and vice versa that the disease could start in the myocardium and spread to the pericardium.
Slide 5-

II. Hyper sensitively reaction. Follow myocardial infarction dressler syndrome ).post pericardits 2nd ry to M.I in 3rd or 4th day of infection.(late presentation ).
Slide 6-

Post pericardiotomy syndrome .auto immune self limiting disease affect pleura and pericardium .common af ter cardiac surgery specially mitral valve “mitral comissuratomy” Serum sickness and drug reaction as (hydralazine) III. Direct and indirect wound as stab wound .
Slide 7-

Iv.Metabolic disorders as uraemia. (most important). Present with pericaditis effusion and espically after introduction of renal dialysis .The pericardial effusion enhanced after renal dialysis . Myxedema. Malignancy like lymphoma. Aortic dissection + myocardial infection.
Slide 8-

Cobalt pear cardiomyopathy. Pear can. Lead to Radiation therpay . Myocarditis cardiomyopathy
Slide 9-

Clinical Finding Depond on the: - Type of inflammation. - Sevirety of inflammation. - Formation of pericardial fluid. Dry pericarditis. Percardial effusion without cardiac temponade. Cardiac temponade. Pericardial constriction.
Slide 10-

ECG:
Slide 11-

1/ Dry Pericarditis or Fibronous: Chest pain: It is precardial, sever, radiate to shoulder, so mimic the acute myocardial infraction pain. But the pain of pericarditis increase intensity with inspiration or lying flat and improve when standing or sit down or leaning forward ( (وضع الساجد. Fever: Arthralgia rigors, anxiaty and general weakness. Symptoms:
Slide 12-

Signs: Pericardial rub: Is the harsh sound continuous atrail systole, Ventricular systole and ventricular diastole. It is superficial sound has no relation to heart sound. Nearly periodical area. and easy to heard when the patient hold it’s breathing so you should differentiate between pleural rub and pericardial rub. Pleural rub might be heard during inspiration. Pericardial rub start to disappear when effusion develops. And pericardial pain improve.
Slide 13-

Lab Finding: CBC – leu kocytosis 20.000. increase sedmentation rate. Increase CRP
Slide 14-

X-Ray: Normal chest X-Ray. No signs of cardiac enlargement. No signs of pulmonary congestion.
Slide 15-

ECHO:
Slide 16-

Symptoms: disapperance of cheast pain. 1. ECG changes - Flat T wave. - Low voltage ECG 2/ Precardial effusion without temponade:
Slide 17-

Signs: Blood pressure normal. Pulse normal. Only heart sound become distant. Invisible cardiac pulse. Pericardial rub might disappear or it may remain and this indication to previous pericarditis so no pain and no rub.
Slide 18-

ECG: Change in T wave not specific for P. effusion. T wave flat or T wave inverted. Low voltage. Low QRS complex.
Slide 19-

ECHO: It is 99% diagnostic to pericardial effusion. ECHO: Showed free area between pericardium and posterior wall of L. ventricle.
Slide 20-

The ECHO not useful in early stage of dry pericarditis but in late when there is fibrosis.
Slide 21-

Differential Diagnosis 3rd heart sound. Normal heart sound. In the pericardial effusion there is distant heart sounds and apical impulse not visible. Heart failure:
Slide 22-

Complication of pericardial effusion: Cardiac temponade 2. Fibrosis: minimal effusion and this called sero constrictive or sub acute inflammation.
Slide 23-

Treatment of pericarditis without effusion: Salicylate NSID in high dose. Bed Rest. most patient respond to those points. If patient after 10 day of starting salicylate or NSIDrugs if still have signs or symptoms of pericarditis corticosteroids can be added but role of corticosteroids is doubt if start from beginning of the disease.
Slide 24-

Treatment of pericardial effusion: Pericardio- synthesis: This is diagnostic and therapeutic. 2. Thoracotomy: ( an open drainage).
Slide 25-

3/ Cardiac Temponade: In Temponade the amount of fluid inside pericardial sac is increased. When intra pericardial pressure equal to the diastolic pressure in the heart. ( the right vertical or right atrial pressure) then temponade develops. The right side of the heart has less diastolic pressure than left side of the heart and for that reason the cardiac temponade compress right side of the heart because the pressure reach to diastolic pressure of right ventricle or right atrium before reach to left ventricle and so all patients present with right side heart failure heart problem.
Slide 26-

Symptoms: Patients is unconscious, severly sweating, dizzness or may reach a circulatory shock.
Slide 27-

Increase venous pressure : Cardiac impulse: Are not palpable. Heart sound: Are distant and this is same as P. effusion. Signs: (Kussmaul’s sign). called inspiratory filling of superior vena cava.
Slide 28-

ECG: Low voltage and T wave change. Non specific change.
Slide 29-

ECHO: Is most helpful diagnotic method for cardiac tamponade. Fluid inside between pericardium and posterior wall of ventride.
Slide 30-

Invasive Method: Abscent.Y Descend: C.Tamponede the diastolic pressure in the pericardial sac equal to diastolic pressure in Rt ventricle and so there is interference with the filling of Rt ventricle and so absent of Y descent. For that reason it is an acute emergency we would remove fluid to give chance to Rt ventricle to dilate.
Slide 31-

Differentia Dignosis From severly P. Emblism or acute myocardial infraction or any acute emergency state. Type of pain is similar But pain of pericardial when lying flat.
Slide 32-

ECG:
Slide 33-

Treatment: 1. pericardio syntheasis:
Slide 34-

4. Constrictive Pericardits There is sero constrictive and constrictive pericarditis. The difference between them, that the sero contrictive affect Rt pericardium + minimal fluid in pericardiuml so we called it sero constrictive or sub acute type. In constrictive pericarditits, whole pericardium is thickened and fibrosis so make thick fibrous layer around heart.
Slide 35-

Symptoms: Is swelling of abdomen and lower limb as it mimic presentation as acute Rt heart failure.
Slide 36-

Dyspnea is minmal in constrictive pericarditis is not presenting symptom but it can occur. Anaroxia. General weakness + wasting. In constrictive pericarditis, the history of previous attack of pericarditis is important.
Slide 37-

Signs: Low blood pressure. Pulsus paradoxus: Is present in constrictive pericarditis and cardiac tamponade and abscent in pericardial effusion without tamponade and in dry pericarditis. (it is change in sytolic blood pressure more than 10 mm of Hg during insiration).
Slide 38-

Arrythmia: (Atrail Fibrillation) in 30% in constrictive pericarditis ( one of causes of artail fibrillation is constrictive pericarditis) high jaqular venous pressure. No deep Y wave descent : This opposite to constrictive pericarditis when there is Y wave (deep descent).
Slide 39-

Rigt hypocondrial pain:
Slide 40-

But in constrictive dilated Rt ventricle at early diastolic rapidy and there is Y rapid descent until the pressure inside Rt ventricle equal to whole distolic pressure in the pericardium so there is squair root phenomena. Percardial knock: Ascitis:
Slide 41-

ECG: Non specific.
Slide 42-

X-Ray: Intraprecardial cacification
Slide 43-

ECHO: Absent of late diastolic filling.
Slide 44-

D.D Superior venacaval ospstruction. Restrective cardiomyopathy. Endomyocardial fibrosis.
Slide 45-

Treatment: Pericardiutomy