Pericarditis Flashcards
(24 cards)
Pericarditis etiology
Viral, mono, HIV, coxsackie
Bacterial, strep, staph, Lyme,
Other;
Fungal,
Drug induced
Trauma
Pericarditis history
Chest pain, stabbing pain, relieved when sitting forward, pleuritic, acute is more painful than chronic
Dyspnea is mild, moderate
Ask about recent fever. Insect bites
DDX pericarditis
PLEURISY
COSTOCONDRITIS
Pneumothorax
GERD
PE
Physical exam for pericarditis includes
Pericardial friction rub,
Decrease in heart sounds
Tachy
Sign of tamponade (emergent)
Work up for pericarditis
EKG, WILL SHOW LOW VOLTAGE IF EFFUSION, PR DEPRESSIONS, DIFFUSE ST ELEVATION BESIDES LEADS AVR
In addition to an ekg for pericarditis what else will you check
Labs, troponin , to rule out an MI
CBC
Chest x ray, cardiomegaly
Echo, to quantify amount of effusion
Clinical diagnosis of pericarditis involve at least 2 of the following
Chest pain, sharp and pleuritic, improved when leaning forward
Pericardial friction rub
PR depression or st elevation
Effusion
Tx for pericarditis
Tx underlying diagnosis
Idiopathic,
- rest,
- NSAIDS , ASPIRIN, IBUPROFEN
Admission criteria for pericarditis
Temp >100.4
Large effusion
Trauma
Myopericarditis
Complication of pericarditis
CHRONIC pericardial effusion
Cardiac tamponade, AVOID ANTICOAGULANT
Myopericarditis, symptom with pericarditis, and trop is detected
Tamponade is what
Hemodynamic compromise shock,
Fluid build up rapid, compressing the heart
What happens in cardiac tamponade,
Rapid accumulation (less amt 200) WORSE OUTCOMES
Or slow accumulation of fluid (2000 ml)
Becks triad in cardiac tamponade is what
Hypotension
Jvd
Muffled heart sounds (due to fluid)
Other clinical signs besides becks triad in cardiac tamponade
Shock appearence e
Tachycardia
Tachypnea
What happens with systolic Bp in tamponade
Decreases greater than 10 mmhg drop upon inspiration
Tamponade vs effusion
Tamponade, means pt is now unstable hemodynamicalky
If patient has pleural effusion main concern is __
Tamponade, worse if a rapid accumulation
Workup for tamponade
Can see swinging heart on a ECHO
ekg will show low voltage, pr depression
AVOID CT
high clinical suspicion, has effusion, and past medical history, trauma
Tx for tamponade
Emergent pericardiocentesis, until surgical intervention
If chronic slow accumulation, pericardiocentesis, not emergent
Pneumopericaridum
Gas in the pericardial sac
Etiology of pneumopericardium
Trauma
Surgery
Infection
Pneumopericardium signs
Metallic heart sounds
Dyspnea
Asymptomatic
