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Curriculum objectives for pericardial diseases: 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? 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?