acute pericarditis

Question 1

Aetiology of acute pericarditis

Answer 1

viral infections (Coxsackie)
tuberculosis
uraemia
post-myocardial infarction
early (1-3 days): fibrinous pericarditis
late (weeks to months): autoimmune pericarditis (Dressler’s syndrome)
radiotherapy
connective tissue disease
systemic lupus erythematosus
rheumatoid arthritis
hypothyroidism
malignancy
lung cancer
breast cancer
trauma

Question 2

Features of acute pericarditis

Answer 2

pleuritic chest pain relieved by sitting forward
non productive cough
dyspnoea
flu like symptoms
pericardial rub

Question 3

ECG findings acute pericarditis

Answer 3

widespread changes
saddle shaped ST elevation
PR depression

Question 4

Investigations acute pericarditis

Answer 4

ECG
transthoracic echocardiography
bloods - inflammatory markers, troponin

Question 5

management of acute pericarditis

Answer 5

outpatient usually
treat underlying cause
avoid strenuous activity
NSAID and colchicine first line for idiopathic or viral pericarditis until symptom resolution