Inflammatory Cardiac Dx

Question 1

Pericarditis - Causes

Answer 1

Bacterial- S.aureus, streptococci, legionella
Viral - Enterovirus, Influenza, mumps
Uraemia
Malignancy
TB
Post Cardiac Surgery
Autoimmune - SLE
Drug - Isoniazide, Procainamide

Question 2

Pericarditis -ECG changes

Answer 2

Stage 1 - Spodicks sign - Downsloping TP segment in lead II, Diff concave STE (I,II, V5-6), PR dep (II), reciprocal STD & PRE in avR.
Stage 2 - normalisation STE, T wave flattening
Stage 3 - T wave inversion, Low voltage +/- alternans

Question 3

Pericarditis - Rx

Answer 3

Colchicine 500mg BD 3/12
Ibuprofen

Question 4

Pericardial Tamponade - Causes

Answer 4

Acute MI w free wall rupture
Post Cardiac Surgery
Type A aortic dissection
Neoplastic
SLE/RA

Question 5

Pericardial Tamponade - C/F

Answer 5

Beck’s Triad- Hypotension, Elevated JVP, Muffled HS
SOB, Pulsus Paradoxus
ECG - small voltage, electrical alternans

Question 6

Pericardial Tamponade - DDx

Answer 6

Massive PE
Tension PTx
Pericarditis
Air embolus
Severe CCF
Cardiogenic shock