Pericarditis

Question 1

What are the causes of pericarditis?

Answer 1

Infection from…
Viruses: Cocksackie B virus, echovirus, CMV, herpes virus, HIV

Staphylococcus, pneumococcus, TB

Malignancy: lung, breast, Hodgkins lymphoma

Heart: heart failure, Dressler’s syndrome, radiation, drugs, rheumatoid diseases

Renal failure

Question 2

Symptoms of pericarditis?

Answer 2

Pleuritic chest pain
Pain worse on lying, better on leaning forward

Question 3

What drugs can precipitate pericarditis?

Answer 3

Anthracycline chemotherapy (Doxorubicin)
Hydralazine
Isoniazid
Methyldopa
Phenytoin
Penicillins (hypersensitivity)

Question 4

What is the first line management of viral pericarditis?

Answer 4

Exercise restriction, NSAIDs + PPI for 2 weeks and colchicine for 3 months

Question 5

What is second line management for viral pericarditis?

Answer 5

Colchicine

Question 6

What is the third line management for viral pericarditis (if cannot tolerate NSAIDs)?

Answer 6

Corticosteroids

Question 7

What is 1st line of bacterial pericarditis?

Answer 7

IV abx +/- pericardiocentesis if purulent exudate present

Question 8

When is pericardectomy indicated in pericarditis?

Answer 8

Adhesions in pericardium or pericardectomy

Question 9

What is the management of non infective pericarditis?

Answer 9

Corticosteroids