Pericarditis

Question 1

exudate or transudate

Answer 1

exudate

Question 2

causes

Answer 2

viral (majority) e.g. resp infection, post MI

Question 3

sx

Answer 3

pain:
retrosternal
sharp or dull
worse on lying flat, relieved by sitting forward
radiating to neck/trapezius

Question 4

what is cardiac tamponade

Answer 4

ventricular filling compromised by pericardial effusion

Question 5

what murmur?

Answer 5

pericardial friction rub (pathognomonic)

Question 6

4 stages of pericarditis ecg

Answer 6

Stage I: diffuse concave-upward ST elevation.
Stage II: ST segments return to baseline; T-wave flattening.
Stage III: T-wave inversion.
Stage IV: gradual resolution of T-wave inversion.

Question 7

ix

Answer 7

ECG
CXR 
FBC  (may show leukocytosis).
ESR and CRP levels (usually raised).
U&E levels (uraemia - can cause it).
Cardiac enzymes
-echo if effusion suspected

Question 8

seen on CXR with pericardial effusion

Answer 8

‘flask-shaped’ cardiac silhouette

Question 9

seen on CXR with pericardial effusion

Answer 9

‘flask-shaped’ cardiac silhouette

Question 10

rx

Answer 10

naproxen, BED REST, usually don’t need admitting

Question 11

causes of chronic pericarditiis (thick fibrous and calcified)

Answer 11

• TB
• Bacterial infection
• Rheumatic heart disease
• Open heart surgery
• Dopamine agonists

Question 12

what is dressler’s syndrome

Answer 12

secondary pericarditis after MI

believed to be autoimmune