Pericarditis Flashcards
What is pericarditis?
Inflammation of the pericardium with/without effusion
What are the two types of effusive pericarditis?
Purulent serous exudate, haemorrhagic exudate
What can cause acute pericarditis?
Infection, autoimmune, secondary metastatic tumours, traumatic, iatrogenic, post cardiac injury
What pathogens can cause pericarditis?
Enteroviruses, adenoviruses, mycobacterium tuberculosis, histoplasma species (most likely if immunocompromised)
What autoimmune conditions can cause pericarditis?
Rheumatoid arthritis, Sjogren’s, SLE
What are symptoms of pericarditis?
Severe chest pain, dyspnoea, cough, hiccups, fever myalgia
What does the severe chest pain feel like?
Sharp, pleuritic with rapid onset, worse when lying flat and on inspiration, relieved by sitting forward, radiates to trapezius ridge
What are signs of pericarditis?
Pericardial rub heard on auscultation, tachycardia, peripheral oedema, increased JVP
What are signs of pericardial effusion?
Bronchial breathing at left base, muffled heart sounds
What is the gold standard investigation?
ECG
What does pericarditis look like on an ECG?
Saddle-shaped ST elevation, diffuse ST elevation in all leads, PR depression
What might you see on a CXR?
Cardiomegaly if effusion
How do you manage pericarditis?
Reduce physical activity, ibuprofen and aspirin for 2 weeks + PPI, Colchicine for 3 months, treat cause
How do you manage pericardial effusion?
Treat the cause, pericardiocentesis - diagnostic if bacterial, therapeutic if cardiac tamponade
