Acute Pericarditis Flashcards
1
Q
Acute Pericarditis Patho
A
- Inflammation of pericardium
- Influx of neutrophils → increased vascularity
- Fibrin deposits on outside of pericardium
2
Q
Causes
A
- Idiopathic & infection
- Most common cause is viral, but can be bacterial or fungal
- Most often follows a respiratory infection
- MI
- Neoplasia, radiation therapy, trauma, renal failure, TB, Lupus (SLE)
3
Q
Manifestations
A
- Progressive, severe, sharp chest pain
- Worse with deep inspiration and lying flat
- Improves with sitting up and leaning forward
- Dyspnea from pain (worry about resp status from shallow breathing)
- Pericardial friction rub
4
Q
Pericardial Effusion
A
- Occurs rapidly or slowly
- Compresses nearby structures
Pulmonary tissue: cough, dyspnea, tachypnea
Phrenic nerve: hiccups
Laryngeal nerve: hoarseness - Heart sounds distant, muffled
- Difficulty breathing & chest pain
- Inflammation → increased vascularity → fluid moves where it shouldn’t
5
Q
Cardiac Tamponade
A
- Develops with increasing volume of pericardial effusion
- Compression of the heart → ineffective pumping
- Acute or subacute
- Chest pain, confusion, anxiety, restlessness, decreased CO, muffled heart sounds, narrow pulse pressure, tachycardia, tachypnea, increased JVD, pulsus paradoxus
- Emergency: put needle in at bedside to drain fluid
6
Q
Diagnostic Studies
A
- Based on history, signs, symptoms
- ECG: ST segment elevation
- Echo: see heart not pumping correctly
- CT/MRI
- Pericardiocentesis: drain fluid from heart
- Labs: leukocytosis, elevated CRP, ESR, troponin
**Troponin indicates cardiac cell death
7
Q
Interprofessional Care
A
- Identify and treat underlying problem and symptoms
- Symptomatic relief: NSAIDs, bedrest
- Antibiotics if bacterial
- Pericardiocentesis
- Pericardial window: cut hole in pericardial sac to drain fluid
- Monitor for complications
- Assist with position changes
- Can turn into chronic pericarditis: difficulty pumping the heart
