10. Neoplasia
Cardiac hemangiosarcoma – in right. atrium mostly
61% cause of effus. Pericarditis
Heart base tumor
Associated with ascending artery and main pulmonary
artery
Aortic body tumor
Ectopic thyroid tumor
Breed predis.- english bulldog, boxer, boston terrier ,
In chronic hypoxia induced hyperplasia and neoplasia
of chemoreceptors
11. Mesothelioma
diffuse neoplasm of the pericardium and other serosal
surfaces
Lymphosarcoma
Rhabdomysarcoma
Fibrosarcoma
13. Pathogenesis
In the early stages
Inflammation Hyperemia Deposition of
Fibrinous Exudate Friction Sound Muffling of
The Heart Sounds Atria and Right Ventricle
Compression CHF
Toxemia
Anaerobic bacteria gas-production washing
machine sound of fluid splashing with each heart beat
14. In the recovery stag
Reabsorption of fluid adhesive pericarditis
In suppurative pericarditis complete adhesion
17. Pulsus paradoxus
Associated with cardiac tamponade
Phasic variation in pulse quality with respiration
≥10 mm Hg decrease in systolic arterial BP with
inspiration during normal breathing
LV stroke volume and systemic arterial BP decreases
with inspiration
23. Electrocardiography
Electrical alternans is evident on this lead II
electrocardiogram from a 10-year-old male Bulldog with a
large pericardial effusion. Note also the small voltage QRS
complexes
Sinus Tachycardia (heart rate about 170 beats/min)
25. Diff. diagnosis
Other cause of Rt. CHF – DCM, tricuspid dysplasia ,
ascites( hepatic disease , Abd. Neoplasia)
Other cause of muffled heart sound- pleural effusion,
thoracic mass , diaphragmatic hernia
Other cuase of low voltage complexe- pleural effusion,
obesity, hypothyroidism
Other cause of cardiac enlargement – DCM, tricuspid
dysplasia, PPDH
26. Treatment & prognosis
Important to differentiate cardiac tamponade from
other causes of right-sided CHF because the treatment
is very different.
Positive inotropic drugs do not ameliorate the signs of
tamponade; diuretics and vasodilators can further
reduce cardiac output and exacerbate hypotension and
shock
Pericardiocentesis is the immediate treatment of
choice, and it also provides diagnostic information
Most signs of CHF resolve after pericardial fluid is
removed
27. Pericardial effusions secondary to other diseases that
cause CHF, congenital malformations, or
hypoalbuminemia do not usually cause tamponade
and often resolve with management of the underlying
condition.
Antibacterial treatment of the specific infection
should be undertaken if possible on the basis of
susceptibility on organisms cultured from the
pericardial fluid
The prognosis varies with the etiological agent but it is
generally grave in cases of septic pericarditis
28. Fifth rib resection and pericardial marsupialization
Pericardial drainage and intrapericardial lavage
Antimicrobial administration
Recurrent effusion that does not respond to repeated
pericardiocentesis and anti inflammatory therapy is
usually treated by subtotal pericardiectomy.
Removal of the pericardium ventral to the phrenic
nerves allows pericardial fluid drainage to the larger
absorptive surface of the pleural space
Neoplastic pericardial effusions are also drained to
relieve cardiac tamponade
29. Surgical therapy is likely to be more effective than
continuous drainage with an indwelling pericardial
catheter, and it also allows removal of penetrating
foreign bodies
30. PERICARDIOCENTESIS
Done immediately in animals with cardiac tamponade.
diuretics or vasodilators without pericardiocentesis
may cause further hypotension and cardiogenic shock.
Pericardiocentesis should be performed under
ultrasonographic guidance and with ECG monitoring.
