Ch. 79 Pericardial and Myocardial Diseases Flashcards
What are the classic
signs and symptoms of pericarditis?
Chest pain, ECG changes, and pericardial friction rub
Fever and myalgias is common
Features of pericarditis chest pain
Sharp, pleuritic, varies with position-relieved with sitting forward and worse with lying down, deep inspiration, or swallowing
What is the most reliable diagnostic tool for pericarditis?
EKG
What are the classic EKG findings for pericarditis?
EKG findings vary and progress.
Initial stage: diffuse ST changes and PR depressions
Middle stage: normalized ST segments and PR segments, but T waves flatten and eventually invert to deep and symmetric waves
In the last stage, the EKG findings resolve, though the inverted T waves may persist
What percentage of patients with pericarditis present with classic symptoms and EKG findings?
only 2/3
How are pericarditis and AMI presentations and EKG findings different?
Pericarditis EKG findings have concave ST elevations and usually don’t have concurrent T wave inversions and they don’t follow a pattern consistent with an artery distribution and Q waves don’t appear.
Ventricular dysrhythmias generally don’t occur with pericarditis and patients with presumed pericarditis who develop V. dysrhythmias should have other diagnoses considered.
How is pericarditis managed?
Treatment of the underlying etiology should be pursued. Otherwise, treatment is focused on symptoms. NSAID’s are first line for pain control and generally are very effective, even very early on.
Colchicine is used to reduce the risk of recurrence and is also used for recurrent cases.
What are the likely causes of recurrent pericarditis?
If recurrent, pericarditis is more likely to be from immune or rheumatologic etiologies.
What are the general categories of causes of pericarditis?
Infectious Post injury Systemic diseases Primary tumors Aortic dissection
