Pericarditis SIM lab

Question 1

Acute Pericarditis:

Answer 1

Acute inflammation of the pericardium

–may cause pericardial effusion

Question 2

Define pericarditis

Answer 2

Inflammation of the pericardium

Question 3

Pericarditis characteristics/ sx&sxs

Answer 3

CP
Pericardial friction rub
referred pain to traps, neck, left shoulder
Leaning forward on exam, better if sitting up
low grade fever
dyspnea- hurts to take a deep breath

Question 4

Describe a friction rub

Answer 4

washing machine like murmur

Question 5

What EKG changes make you think pericarditis

Answer 5

Defuse ST elevation- all leads

also PR depression

Question 6

Classic story for pericarditis

Answer 6

Post viral infection 1 week prior

Question 7

Concerning complications

Answer 7

cardiac tamponade or pericardial effusion

Question 8

What life threatening conditions must you rule out

Answer 8

MI and aortic dissection

Question 9

Treatment?

Answer 9

High dose aspirin until no longer symptomatic, NSAIDs- ibuprofen. Colchicine for 3 months, prednisone

Question 10

If there is a pericardial effusion what is the treatment?

Answer 10

pericardiocentesis

Question 11

Serous pericarditis:

Answer 11

non-infectious etiology (i.e. Rheumatoid Arthritis, SLE)

If fibrin adhesion occurs–> fibrinous or serofibrinous (ex-post MI)

Question 12

P’s of Pericarditis:

Answer 12

persistent, pleuritic, postural pain, and pericardial friction rub

Question 13

Etiologies:

Answer 13

• *Viral MC cause (esp enteroviruses: coxsackie and echovirus), adenovirus
• Idiopathic, neoplastic, Dressler’s syndrome( pericarditis s/p MI), autoimmune, systemic, uremia, bacterial, XRT,
• Drugs (procainamide, INH, hydralazine)

Question 14

Pericarditis: clinical manifestations

Answer 14

1. Chest Pain: Pleuritic (sharp and worse with inspiration