Pericardial Disease

Question 1

What are the history features and examination findings you might find in a person developing pericardial tamponade?

Answer 1

• Dyspnoea, chest pain
• Hypotension
• Rising JVP
• Muffled heart sounds
• Tachycardia

Question 2

What investigations might you perform for someone you suspected of pericardial tamponade?

Answer 2

• ECG - low voltage
• TTE - large effusion, chamber collapse
• CXR - large shadow

Question 3

If someone has established cardiac tamponade, how might you manage them?

Answer 3

• Pericardiocentesis +/- surgical drainage (blood, pus etc.)

Question 4

In someone with pericarditis, what findings might you see on history and examination?

Answer 4

• Chest pain (MI-like or pleuritic)
  
  • Relief with sitting forward
• Symptoms and signs of right heart failure
• Friction rub (end expiration, left sternal edge)
• Risk factors (infection, some drugs, radiation)

Question 5

What ECG findings might you expect in someone with pericarditis?

Answer 5

• Widespread ST elevation (concave-up) and PR depression