ACUTE PERICARDITIS

Question 1

Definition

Answer 1

Inflammation of the pericardial sac

Question 2

Causes (8)

Answer 2

1- Idiopathic (post viral): preceded by flulike, respiratory, or GI symptoms
2- Infectious: Viral (coxsackie, echovirus, adenovirus), Bacterial (TB), Fungal, Toxoplasmosis
3- Acute MI: First 24 hours
4- Uremia
5- Collagen vascular diseases (SLE, Wegner’s, RA, PAN)
6- Neoplasms: Hodgkin lymphoma, breast ca, lung ca
7- Amyloidosis, radiation, trauma
8- After surgery

Question 3

Clinical Features (4)

Answer 3

1- Chest pain; retrosternal, radiates to the neck and back, aggravated by coughing, inspiration, and lying supine, relieved by leaning forward
2- Fever and leukocytosis
3- Friction rub; heard best during expiration, very specific but not always present
4- Complications: pericardial effusion and cardiac tamponade

Question 4

Investigations (2)

Answer 4

1- ECG: diffuse ST elevation in all leads and PR depression (more specific)
2- Echo: often normal unless there is pericardial effusion

Question 5

Treatment (2)

Answer 5

1- Aspirin or Ibuprofen + Colchicine and bed rest are the mainstay of therapy
2- If no response —> glucocorticoids