Question

What is the pathophysiology of pericarditis with tamponade including the risk factors? (in paragraph and diagram form)

Answer 1

The heart enclosed in a double walled structure called pericardium. Pericardial fluid present in this layer keeps the layers from rubbing against each other and causing friction. Pericarditis is the inflammation of pericardium, the fibrous envelop support and protects the heart. Cardiac tamponade is a complication of pericarditis in which pericardial effusion causes fluids to build up around the heart and compress it.

Pathophysiology and risk factors.

Risk factors

1. Men age 20-50 years

2. Bacterial , fungal or viral infection

3. Primary metastasis from lungs, breast and other organs.

4. High dose radiation to the chest .

5.Hypersensitivity or autoimmune disease such as rheumatic fever

6. Medications such as hydralazine and procainamide

7. Postcardiac injury, such as MI( which later causes autoimmune reaction in the pericardium), trauma, and surgery that leaves the pericardium intact but allows blood to leak into pericardial cavity.

8. Aortic aneurysm with pericardial leakage

9. Myxedema with cholesterol deposits in the pericardium.

Pathophysiology

A pathogen or other substance attacks the pericardium starting the inflammatory response. Acute pericarditis (pericarditis lasts for less than 6 months) may be fibrinous or effusive , with serous , purulent, or hemorrhagic exudate. Chronic pericarditis is characterised by dense fibrous pericardial thickening and lasts a long time. Chronic pericarditis causes pericardial effusion and results in Cardiac tamponade. Extra fluid put pressure on the heart and prevent heart from properly filling the blood.