Acute Pericarditis Flashcards
What is acute pericarditis?
Acute pericarditis is a condition referring to inflammation of the pericardial sac, lasting for less than 4-6 weeks.
What are the common aetiologies of acute pericarditis?
Common aetiologies include viral infections (Coxsackie), tuberculosis, uraemia, post-myocardial infarction, radiotherapy, and connective tissue diseases.
What are the early and late causes of pericarditis?
Early causes (1-3 days) include fibrinous pericarditis; late causes (weeks to months) include autoimmune pericarditis (Dressler’s syndrome).
What are some connective tissue diseases associated with acute pericarditis?
Systemic lupus erythematosus, rheumatoid arthritis, and hypothyroidism are associated connective tissue diseases.
What are the features of acute pericarditis?
Features include chest pain (may be pleuritic and relieved by sitting forwards), non-productive cough, dyspnoea, flu-like symptoms, and pericardial rub.
What ECG changes are seen in acute pericarditis?
ECG changes include global/widespread changes, ‘saddle-shaped’ ST elevation, and PR depression (most specific ECG marker for pericarditis).
What investigations should be performed for suspected acute pericarditis?
All patients should have transthoracic echocardiography and blood tests for inflammatory markers and troponin.
What is the management approach for acute pericarditis?
Most patients can be managed as outpatients; those with high-risk features should be managed as inpatients.
What is the recommended treatment for viral pericarditis?
A combination of NSAIDs and colchicine is generally used as first-line treatment for acute idiopathic or viral pericarditis.
What should patients avoid during recovery from acute pericarditis?
Strenuous physical activity should be avoided until symptom resolution and normalisation of inflammatory markers.
How long should athletes avoid strenuous exercise after acute pericarditis?
Athletes should avoid strenuous exercise for at least 3 months until symptoms have resolved and investigations have normalised.
