Pericardial Dz

Question 1

Drug induced pericarditis/effusion

Answer 1

Procainamide, hydralazine, INH, CsA

Question 2

Pericarditis treatment

Answer 2

Ibuprofen 600mg TID x 7-14 d with taper
+- colchicine 2mg x 1, 1mg bids 3 mo
Steroids only for systemic rheum or autoimmune disease, uremic, pregnancy contraindications to NSAIDs or refractory idiopathic disease. Increase rate of pericarditis recurrence
Avoid A/C

Question 3

Recurrent pericarditis treatment

Answer 3

NSAIDS, but add colchicine 1mg bid x 6 mo
Consider per cutaneous or surgical drain
rF: no NSAIDs response after 7d, subacute, Ig effusion/tamponade, t>38

Question 4

Cardiogenic shock without pulmonary edema

Answer 4

Pericardial tamponade

Question 5

Cardiac cath findings in tamponade

Answer 5

Right heart pressure elevation 15-30mmHg, equalization of intrapericardial and diastolic pressures RA, RV, PCWP, blunted y descend, improved SV postpericardiocentesis = ultimate proof of tamponade

Question 6

Tamponade treatment

Answer 6

Volume, inotropes but avoid BB

Pericardiocentesis