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Board Basics Review > Acute Pericarditis > Flashcards

Acute Pericarditis Flashcards

1
Q

MC sx of acute pericarditis

A
  • acute sharp or stabbing substernal CP
  • worse w/ inspiration and when lying flat
  • alleviated when sitting and leaning forward
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2
Q

possible medical hx may include:

A
  • preceding viral sxs
  • cancer (current or past)
  • recent trauma
  • arthralgia, or arthritis (suggesting systemic rheumatic disease)
  • MI
  • recent thoracic surgical procedures
  • hydralazine, phenytoin, minoxidil
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3
Q

characteristic PE finding

A

2- or 3-component pericardial friction rub

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4
Q

PE finding that may be present in pericardial tamponade

A

pulsus paradoxus 10 mmHg or more

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5
Q

typical ECG findings

A
  • DIFFUSE STE w/ upward concave movement (w/o reciprocal STD)
  • PR-segment depression in limb leads
  • PR-segment elevation in aVR
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6
Q

possible ECG finding in pts w/ large pericardial effusions

A

electrical alternans (alternating high- and low-voltage QRS complexes)

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7
Q

test that may show effusion or early tamponade

A

echocardiogram

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8
Q

ECG features differentiating acute pericarditis from MI:

acute pericarditis: ST-segment contour

A

conCAVE upwards

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9
Q

ECG features differentiating acute pericarditis from MI:

acute pericarditis: ST-segment lead involvement

A

DIFFUSE

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10
Q

ECG features differentiating acute pericarditis from MI:

acute pericarditis: reciprocal ST-T changes

A

NO

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11
Q

ECG features differentiating acute pericarditis from MI:

acute pericarditis: PR-segment abnormalities

A

YES

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12
Q

ECG features differentiating acute pericarditis from MI:

acute pericarditis: pathologic Q waves

A

NO

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13
Q

ECG features differentiating acute pericarditis from MI:

myocaridal ischemia: ST-segment contour

A

conVEX upwards

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14
Q

ECG features differentiating acute pericarditis from MI:

myocaridal ischemia: ST-segment lead involvement

A

LOCALIZED

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15
Q

ECG features differentiating acute pericarditis from MI:

myocaridal ischemia: reciprocal ST-T changes

A

yes

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16
Q

ECG features differentiating acute pericarditis from MI:

myocaridal ischemia: PR-segment abnormalities

A

no

17
Q

ECG features differentiating acute pericarditis from MI:

myocaridal ischemia: pathologic Q waves

A

yes

18
Q

first-line tx

A
  • aspirin (preferred after MI)
  • NSAIDs
  • NSAIDs and colchicine
19
Q

which tx is a/w lower rates of tx failure and recurrent pericarditis?

A

NSAIDs and colchicine

20
Q

tx if pericarditis does NOT respond to aspirin or NSAIDs or is related to AI process

A

2-3 day course of glucocorticoids

21
Q

when do you tx acute pericarditis w/ steroids?

A
  • NO response to aspirin or NSAIDs

- or related to AI process

22
Q

tx for tamponade or hemodynamic instability

A

emergent pericardiocentesis

Board Basics Review (24 decks)

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