Pericardial Disease - Pericarditis

Question 1

What are the layers of the heart from inner to outermost layer?

Answer 1

Endocardium
Myocardium
Epicardium or the visceral layer of the serous pericardium
Pericardial cavity
Parietal layer of the serous pericardium
Fibrous pericardium

Question 2

What is pericarditis?

Answer 2

Inflammation of the pericardial layers with or without myocardial involvement

Question 3

Causes?

Answer 3

Idiopathic

Can be secondary to:

Infection
Post MI
Dissection of aorta
Neoplasia

Question 4

Symptoms?

Answer 4

Fever

Pleuritic chest pain with that is worse on inspiration and when lying down

Question 5

Signs?

Answer 5

Pericardial rub may be heard

Raised JVP if tamponade

Question 6

What investigations can be done?

Answer 6

ECG
Echo
CxR
Bloods

Question 7

What will an ecg look for?

Answer 7

Saddle shaped ST segment elevation

Question 8

What is an Echo looking for?

Answer 8

Suspected pericardial effusion

Question 9

What are bloods looking for?

Answer 9

FBC - infection check

Troponin levels - raised if myocardial involved

Question 10

Treatment?

Answer 10

Analgesia and anti-inflammation via NSAIDs

Colchicine if NSAIDS fail to work

Question 11

What NSAIDs are used?

Answer 11

Ibuprofen

Or high dose Aspirin if ibuprofen is contraindicated

Question 12

What causes contraindication of ibuprofen?

Answer 12

If patient is post MI as ibuprofen can affect healing of heart muscle