Recommended
More Related Content
What's hot
What's hot (20)
Similar to Pericarditis
Similar to Pericarditis (20)
More from Usman Shams
More from Usman Shams (20)
Recently uploaded
Recently uploaded (20)
Pericarditis
- 2. PERICARDIUM • Normally 30-50 ml clear serous fluid • TWO LAYERS • Visceral (Epicardium) • Parietal (Fibrous pericardium) • PERICARDIAL EFFUSIONS TAMPONADE • Ruptured MI • Traumatic perforation • Ruptured aortic dissection
- 3. • SEROUS: Rheum. Fever (RF), SLE, scleroderma, tumors, uremia • FIBRINOUS: MI (Dressler), uremia, radiation, RF, SLE, s/p open heart surgery • PURULENT: infective, bacterial • HEMORRHAGIC: Malignancy, TB • CASEOUS: TB • CHRONIC: (ADHESIVE, CONSTRICTIVE)
- 4. TYPES OF PLEURAL EFFUSIONS • Serous effusions • Fluid accumulates slowly and is well tolerated • Most common causes are CHF & hypoproteinemia. • Serosanguineous effusions • Usually result from blunt chest trauma. • Chylous fluid accumulations • Due to lymphatic obstruction (benign or malignant). • Hemopericardium • Traumatic perforation • Cardiac rupture • Intrapericardial aortic rupture
- 6. SEROUS PERICARDITIS • Nonbacterial causes • Microscopically there is scant pericardial acute and chronic inflammatory infiltrate, mostly lymphocytes. •
- 7. FIBRINOUS PERICARDITIS • Most common clinical form of pericarditis. • Associated by pericardial friction rub. • Exudate may either be completely absorbed or can organize leaving delicate stringy adhesions (Adhesive pericarditis) or there may be a plaque-like thickening of epicardium.
- 8. A window of adherent pericardium has been opened to reveal the surface of the heart. There are thin strands of fibrinous exudate that extend from the epicardial surface to the pericardial sac. This is typical for a fibrinous pericarditis.
- 10. SUPPURATIVE PERICARDITIS • Purulent pericarditis is typically composed of 400 to 500 ml of thin-to-creamy pus with erythematous, granular serosal surfaces. • Clinical presentation: High fever ; Rigors ; Friction rub • On organization: Constrictive / Mediastino- pericarditis
- 11. Acute suppurative pericarditis as an extension from a pneumonia. Extensive purulent exudate is evident in this in situ photograph.
- 12. This is a purulent pericarditis. Note the yellowish exudate that has pooled in the lower pericardial sac seen having been opened here.
- 13. CASEOUS PERICARDITIS A tuberculous pericarditis can produce extensive granulomatous inflammation with calcification that can severely restrict cardiac function
- 14. HEMORRHAGIC PERICARDITIS • The term hemorrhagic pericarditis is used when fibrinous or suppurative pericarditis exudate is mixed with blood oozing into the pericardial sac. • It usually organizes with or without calcification.
- 15. CHRONIC OR HEALED PERICARDITIS • An acute pericarditis on healing may have: • Complete resolution • Pericardial fibrosis • Thick nonadherent epicardial plaque • Thin delicate adhesions • Massive thick adhesions
- 16. ADHESIVE MEDIASTINO- PERICARDITIS • It is a clinically significant pericarditis in which the cavity of pericardial sac is obliterated and the parietal pericardium is adherent to mediastinal tissues. • The heart contracts against the load of all attached structures. • There is subsequent hypertrophy of ventricles and later dilation.
- 17. CONSTRICTIVE PERICARDITIS • It is a clinically significant pericarditis with markedly thick (up to 1 cm thick) dense fibrous obliteration of the pericardial sac with or without calcification. • The heart is encased with limited diastolic expansion and restricted cardiac output.