Pericardial disease Flashcards
What is acute pericarditis?
Inflammation of the pericardium
What are causes of acute pericarditis?
Idiopathic Virus, bacteria, autoimmune Drugs e.g. hydralazine, penicillin, isoniazid Metabolic trauma
What are Sx of acute pericarditis
Central chest pain, worse inspiration and lying flat
Pericardial rub on auscultation
Effusion or tamponade can occur if severe
What Ix in pericarditis?
ECG: concave, saddle-shaped ST segment elevation and PR depression
Bloods: infection markers, troponin
CXR cardiomegaly if effusion
What is Rx of pericarditis?
NSAIDs or aspirin + PPI
Colchicine can reduce recurrence
Treat infective cause
What is a pericardial effusion?
Accumulation of fluid in pericardial sac.
What are causes of pericardial effusion?
• Pericarditis
• Myocardial rupture
• Aortic dissection
Malignancy
What are Sx of pericardial effusion?
SOB, chest pain, compression e.g. hiccups or nause, muffled heart sounds
What are Ix in pericardial effusion
CXR: shows cardiomegaly if > 300ml
ECG low voltage QRS
What is Rx of pericardial effusion
Pericardiocentesis diagnostic and therapeutic
What is cardiac tamponade
Pericardial effusion with raised intra-pericardial pressure, reduced ventricular filling, and drop in CO
What are Sx of tamponade?
increased pulse, low BP (shock)
pulsus paradoxus:
raised JVP
kussmaul signs
Falling BP, rising JVP, muffled heart sounds= Becks triad
What Ix and Rx in tamponade?
Echo is diagnostic.
Urgent pericardicentesis, expert help.
What is Dressler syndrome
autoimmune response mounted by body after injury to myo/pericardium e.g. an MI
What are Sx of Dressler syndrome
fever, pericarditis, pleuritic chest pain +/- pericardial effusion. Usually occurs 2-3 weeks after the initial injury.
