Acute pericarditis

Question 1

Acute pericarditis

Answer 1

Acute pericarditis is inflammation of the pericardium (the flexible two-layered sac that envelops the heart)

Question 2

Features of acute pericarditis

Answer 2

o chest pain: may be pleuritic. Is often relieved by sitting forwards
o other symptoms include non-productive cough, dyspnoea and flu-like symptoms
o pericardial rub
o tachypnoea
o tachycardia

Question 3

Causes of pericarditis

Answer 3

o	viral infections (Coxsackie)
o	tuberculosis
o	uraemia (causes 'fibrinous' pericarditis)
o	trauma
o	post-myocardial infarction, Dressler's syndrome
o	connective tissue disease
o	hypothyroidism
o	malignancy

Question 4

Investigations for acute pericarditis

Answer 4

ECG changes
> ‘saddle-shaped’ ST elevation
> PR depression: specific ECG marker for pericarditis

All patients with suspected acute pericarditis should have transthoracic echocardiography

Question 5

ECG changes in acute pericarditis

Answer 5

ECG changes
> ‘saddle-shaped’ ST elevation
> PR depression: specific ECG marker for pericarditis

Question 6

Management of acute pericarditis

Answer 6

o treat the underlying cause
o a combination of NSAIDs and colchicine is now generally used for first-line for patients with acute idiopathic or viral pericarditis