Acute Pericarditis

Question 1

Pericarditis features?

Answer 1

Pericarditis is one of the differentials of any patient presenting with chest pain.

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

Question 2

Causes of acute pericarditis?

Answer 2

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

Question 3

Investigations for acute pericarditis?

Answer 3

ECG changes
- the changes in pericarditis are often global/widespread, as opposed to the ‘territories’ seen in ischaemic events
- ‘saddle-shaped’ ST elevation
- PR depression: most specific ECG marker for pericarditis

all patients with suspected acute pericarditis should have transthoracic echocardiography

Question 4

Management acute pericarditis?

Answer 4

treat the underlying cause

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