Diseases of the Pericardium

Question 1

What causes acute pericarditis?

Answer 1

Most often of idiopathic or viral cause and is usually a self-limited illness.

Infectious causes
- viral
- tuberculosis
- pyogenic bacteria

Noninfectious causes
- postmyocardial infarction or after cardiac surgery
- uremia
- neoplastic disease
- radiation induced
- connective tissue diseases
- drug induced

Question 2

Acute pericarditis is characterized by three stages. What are these stages?

Answer 2

1) local vasodilation with transudation of protein-poor, cell-free fluid into the pericardial space
2) increased vascular permeability with leak of protein into the pericardial space
3) leukocyte exudation, initially by neutrophils, followed later by mononuclear cells

Question 3

Common clinical findings in acute pericarditis include:

Answer 3

• pleuritic chest pain
• fever
• pericardial friction rub
• diffuse ST-segment elevation on ECG, often accompanied by PR segment depression

Question 4

What is the treatment for acute pericarditis?

Answer 4

• rest
• nonsteroidal anti-inflammatory drug
• colchicine may reduce the frequency of recurrences and shorten the duration of the acute illness

Question 5

What should not be used for acute pericarditis?

Answer 5

Glucocorticoid drugs as they increase the likelihood of recurrences.

Question 6

Complications of pericarditis include:

Answer 6

• cardiac tamponade (accumulation of pericardial fluid under high pressure, which compresses the cardiac chambers)
• constrictive pericarditis (restricted filling of the heart because of the surrounding rigid pericardium)