pericardial disease Flashcards
(15 cards)
acute pericarditis
inflammation of pericardial sac lasting less than 4-6wks
causes of acute pericarditis
viral infections - coxsackie
TB
post mI
- 1-3days - fibrinous pericarditis
- wks-months - autoimmune, Dresslers
connective tissue - SLE, RA
malignancy - lung, breast
trauma
acute pericarditis features
chest pain - relieved by sitting forward
non productive cough, flu sx
pericardial rub
acute pericarditis investigations
ECG
transthoracic echo - all with suspected must get
bloods - inflam markers, troponin
ECG changes in acute pericarditis
saddle shaped ST elevation
PR depression - most specific
(changes are more global/widespread compared to ischaemic events)
management of acute pericarditis
first line = NSAIDs + colchicine
- until sx settle
treat underlying, avoid strenuous exercise
Becks triad
CARDIAC TAMPONADE
- hypotension
- raised JVP
- muffled hearts sound
features of cardiac tamponade
- becks triad - hypotension, raised JVP, muffled HS
- tachycardia
- absent Y descent on JVP
- pulse paradoxus - large drop in BP during inspiration
ECG - electrical alternans
cardiac tamponade vs constrictive pericarditis
cardiac tamponade
- absent Y descent
- pulsus paradoxus
constrictive pericarditis
- X + Y present in JVP
- no pulsus paradoxus
- pericardial calcification on CXR
management of cardiac tamponade
urgent pericardiocentesis
causes of contrictive pericarditis
any causes of pericarditis
esp TB
contrictive pericarditis presentation
right heart failure - raised JVP, ascites, oedema, hepatomegaly
pericardial knock - loud S3
JVP - prominent X + Y descent
Kussmauls sign positive
contrictive pericarditis on CXR
pericardial calcification
cardiac tamponade definitive diagnosis
echo !!
ECG shows widespread ST elevation and PR depression
pericarditis
