Download Curriculum objectives for pericardial diseases:

Curriculum objectives for pericardial diseases:
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Briefly describe the anatomy of the pericardium.
Name the myriad of conditions that can cause pericardial diseases. Try to come
up with at least 5-6 broad categories and list a few diseases in each category if
possible.
o i.e. idiopathic infectious (viral, bacterial…etc), autoimmune (lupus,
RA.e.tc), diseases of contiguous structures (post-infarction, Dressler’s,
myocarditis), disorders of metabolism (uremia, hypothyroid),
neoplastic…etc.
Name the main categories of pericardial diseases (driving at pericardial
inflammation, effusion, and constriction). Can they co-exist with each other?
Acute pericarditis
 What is the clinical presentation of acute pericarditis? What is the character of
the chest pain that the patient complain of? What position that the patient
assumes exacerbates the pain?
 What is the pathonomonic physical finding of acute pericarditis? Can you
describe what it sounds like?
 What is the EKG finding of acute pericarditis? Does it go through several stages?
 What is the treatment for acute pericarditis? Should this condition be treated in an
inpatient or an outpatient setting?
 What are the most frequent etiologies of acute pericarditis? Is an exhaustive
work-up to find the cause always (or often) needed?
 When should we order an echocardiogram to assess acute pericarditis?
 What are some of the potential long-term complications of acute pericarditis?
Pericardial Effusion:
 What is the range of clinical presentation of someone with a pericardial effusions?
 What characteristics of the effusion determine the patient’s clinical symptoms?
Will a bigger effusion always result in more symptoms?
 Describe the pathophysiology of cardiac tamponade.
 Describe the hemodynamic findings of cardiac tamponde.
 What does the patient complain of? What are some findings on exam?
 What is pulsus paradoxus? What is the pathophysiology underlying this findng?
 Describe in detail how you measure pulsus parodoxus. Please make sure you can
perform this exam! This maybe life-saving.
 Name some of the salient echocardiographic findings of cardiac tamponade.
Which signs are more sensitive? Which are more specific? What is the caveat
when there is substantial pulmonary hypertension?
 What can you do to stabilize someone with cardiac tamponade before they go for
definitive treatment (i.e.- pericardialcentesis or pericardial window)?
 What is the difference between pericardialcentesis and pericardial window?
When should the patient get pericardiocentesis? A pericardial window?
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After the effusion has been drained, how do you determine whether the drainage
has been adequate? When should you pull the pericardial drain?
What is effusive- constrictive pericarditis? How do you make the diagnosis? (this
last question maybe too advanced, although practical).
Constrictive Pericarditis:
 What is the pathophysiology underlying constrictive pericarditis?
 What is the clinical presentation of this disease?
 How can the diagnosis be made?
 What is the definitive treatment?