Pericardial disease Flashcards
What is acute pericarditis?
Acute pericarditis is a condition referring to inflammation of the pericardial sac, lasting for less than 4-6 weeks.
What are the aetiologies of acute pericarditis?
Aetiologies include viral infections (Coxsackie), tuberculosis, uraemia, post-myocardial infarction, radiotherapy, and connective tissue diseases such as systemic lupus erythematosus and rheumatoid arthritis.
What are the early and late causes of pericarditis?
Early causes (1-3 days) include fibrinous pericarditis, while late causes (weeks to months) include autoimmune pericarditis (Dressler’s syndrome).
What are common features of acute pericarditis?
Common features include chest pain (often pleuritic and relieved by sitting forwards), non-productive cough, dyspnoea, flu-like symptoms, and pericardial rub.
What are the ECG changes associated with acute pericarditis?
ECG changes include global/widespread changes, ‘saddle-shaped’ ST elevation, and PR depression (most specific ECG marker for pericarditis).
What investigations should be conducted for suspected acute pericarditis?
All patients with suspected acute pericarditis should have transthoracic echocardiography and blood tests for inflammatory markers and troponin.
What is the management approach for acute pericarditis?
Most patients can be managed as outpatients, while high-risk patients should be managed as inpatients. Treatment includes addressing underlying causes and avoiding strenuous physical activity until symptom resolution.
What is the first-line treatment for acute idiopathic or viral pericarditis?
A combination of NSAIDs and colchicine is generally used as first-line treatment until symptom resolution and normalisation of inflammatory markers (usually 1-2 weeks), followed by tapering of the dose.
