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ANKI Cardiovascular > [9] Acute Pericarditis > Flashcards

[9] Acute Pericarditis Flashcards

1
Q

What is pericarditis?

A

Inflammation of the sac surrounding the heart

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2
Q

What is acute pericarditis?

A

A type of pericarditis usually lasting less than 6 weeks

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3
Q

What are the causes of pericarditis?

A
  • Idiopathic
  • Viruses
  • Bacteria
  • Fungi
  • Parasites
  • Autoimmune system
  • Drugs
  • Metabolic abnormalities
  • Trauma
  • Surgery
  • Malignancy
  • Radiotherapy
  • MI
  • Chronic heart failure
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4
Q

What are the viral causes of pericarditis?

A
  • Coxsackie
  • Echovirus
  • EBV
  • CMV
  • Adenovirus
  • Mumps
  • Varicella
  • HIV
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5
Q

What are the bacterial causes of pericarditis?

A
  • TB
  • Lyme disease
  • Q fever
  • Pneumonia
  • Rheumatic fever
  • Staphs
  • Streps
  • Mycoplasma
  • Legionella
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6
Q

What are the autoimmune causes of pericarditis?

A
  • SLE
  • RA
  • Vasculitides
  • IBD
  • Sarcoidosis
  • Amyloidosis
  • Dressler’s
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7
Q

What drugs can cause pericarditis?

A
  • Procainamide
  • Hydralazine
  • Penicillin
  • Isoniazid
  • Chemotherapy
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8
Q

What are the metabolic causes of pericarditis?

A
  • Anorexia nervosa
  • Hypothyroidism
  • Uraemia
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9
Q

What are the signs and symptoms of pericarditis?

A
  • Central chest pain, worse on inspiration or lying flat
  • Fever
  • Pericardial friction rub
  • Evidence of pericardial effusion or tamponade
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10
Q

What investigations are involved in the diagnosis of pericarditis?

A
  • ECG
  • Blood tests
  • Chest x-ray
  • Echo if suspected pericardial effusion
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11
Q

What does the ECG show in pericarditis?

A

Classically shows concave (saddle-shaped) ST segment elevation and PR depresion, but may be normal or non-specific

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12
Q

Which pericarditis patients can be managed in an outpatient setting, without the need for hospital

A

Stable patients

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13
Q

What is involvement in the outpatient management of pericarditis?

A
  • Treatment of underlying cause
  • Rest, and avoidance of any demanding physical activity
  • NSAIDs
  • Colchine
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14
Q

What NSAIDs are given first line in the outpatient management of pericarditis?

A

Naproxen 250mg 6-8 hourly

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15
Q

How long should NSAIDs be given in the outpatient management of pericarditis?

A

7-14 days, and then the dose should be tapered until resolution of symptoms and improvement in CRP and ESR readings

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16
Q

What is the advantage of using colchine in outpatient management of pericarditis?

A
  • It has been shown to result in significantly fewer recurrences and long symptom free periods
  • When attacks occur, they are weaker and shorter in nature
17
Q

When is admission to hospital inidicated in pericarditis?

A
  • Evidence suggesting a cardiac tamponade
  • A large pericardial effusion
  • Immunosuppressed state
  • Patients on warfarin
  • Acute trauma
  • Failure to respond within 7 days to NSAIDs

ANKI Cardiovascular (24 decks)

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