This infographic breaks down the different responses of the heart muscle to myocardial ischemia, from early reversible states to irreversible damage. This infographic dives into the pathophysiology and clinical presentation of effusive-constrictive pericarditis through five essential questions:
- How does pericardial tamponade lead to hypotension?
- Pericardial pressure rises, reducing diastolic filling and preload. This leads to decreased stroke volume (SV) and cardiac output (CO), with potential diastolic collapse as pressure increases across chambers.
- What are clinical markers of pericardial tamponade?
- Although no single marker is diagnostic, tachycardia is often present in 81-100% of cases. Diagnosis requires synthesizing multiple findings.
- What is pulsus paradoxus?
- Pulsus paradoxus refers to an exaggerated drop in blood pressure during inspiration (>10-12 mmHg). It results from ventricular interdependence, where the expansion of the right ventricle limits left ventricular filling.
- What are the signs of cardiac tamponade on imaging?
- Imaging features include collapse of the right ventricle (RV) and right atrium (RA), dilated inferior vena cava (IVC) without collapse, and a >30% drop in mitral valve (MV) flow with inspiration.
- What is effusive-constrictive pericarditis?
- This condition is defined by reduced pericardial compliance along with a significant effusion. Even after effusion drainage, constrictive physiology and elevated RA pressures persist, complicating the treatment.
The infographic emphasizes the complexity of diagnosing and managing effusive-constrictive pericarditis, with further details available through the associated blog and podcast episode – 72. Case Report: Effusive Constrictive Pericarditis – University Hospitals Case Western
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