Pericardial disease Flashcards
1
Q
What are the potential causes of pericarditis?
A
Post-MI SLE RA IBD Phenytoin Hydralazine Anti-neoplastic drugs Neoplasms Radiation therapy Trauma Uraemia Myxoedema Rheumatic fever
2
Q
What is the characteristic ECG fin find in pericarditis?
A
Global saddle-shaped ST elevation
3
Q
What is the management of pericarditis?
A
NSAIDs (+PPIs) Colchicine Corticosteroids Exercise restriction IV Abx (if infectious cause) Treatment of the underlying cause
4
Q
Describe the SOCRATES presentation of pericarditis?
A
S - retrosternal / central chest O - sudden C - sharp / pleuritic R - neck, arms or left shoulder A - fever, myalgia T - constant, not related to exertion E - exacerbated by lying flat or inspiration, alleviated by sitting forwards S - severe
5
Q
What are the potential causes of pericardial effusion?
A
Lung, breast or haematological cancer Viral / bacterial /fungal pericarditis TB Chagas disease Post-surgery or post-cardiac intervention Idiopathic Trauma Radiation therapy Heart failure Aortic dissection Post-MI Uraemia pericarditis Dialysis pericarditis Amyloidosis SLE Hypothyroidism Hydralazine Procainamide Isoniazide Antineoplastic drugs
6
Q
What are the potential presenting features of pericardial effusion?
A
Chest pain Dyspnoea Malaise Friction rub Elevated JVP Distant heart sounds Pulsus paradoxus
7
Q
How is pericardial effusion managed?
A
Pericardiocentesis (this is both therapeutic and diagnostic)
8
Q
What is involved in Beck’s triad which occurs in cardiac tamponade?
A
Hypotension
Elevated JVP
Distant heart sounds
9
Q
What does electrical alternans on ECG indicate?
A
Cardiac tamponade
