Acute Pericarditis

Question 1

Acute Pericarditis

Answer 1

Inflammation of the pericardium
Two layers 
Inner serous – visceral
Out fibrous – parietal 
Pericardial space
10-15 mL serous fluid between

Question 2

Etiology and Patho

Answer 2

Idiopathic
Infection: most commonly viral but can be bacterial/fungal
MI: acute and dressler syndrome
Acute S/S 2-3d later
Dressler: 4-6w after MI
Neoplasia, radiation therapy, trauma, renal failure, TB, SLE

Question 3

Clinical Manifestations

Answer 3

Progressive, severe, sharp chest pain
Worse with deep inspiration and lying flat
Improves with sitting up and leaning forward (decreases pressure of chest on heart)
Dyspnea (r/t pain)
Pericardial friction rub ** = hallmark sign (have them hold their breath to make sure not pleural rub)

Question 4

Complications

Answer 4

• Pericardial effusion (>15mL)
• Compress nearby structures
• Cardiac tamponade: heart cannot pump effectively due to increased volume of fluid in pericardium

Question 5

Diagnostics

Answer 5

Based on history, signs, symptoms (past MI)
ECG: might have STEMI
Echocardiogram
CT scan/MRI
Pericardiocentesis: fluid culture
Lab findings: leukocytosis, elevated CRP, ESR, troponin (MI)