Pericardidits, pericardial effusion + cardiac tamponade

Question 1

Causes of acute pericarditis

Answer 1

Idiopathic
Secondary to:
- viruses, bacteria or fungi
- drugs
- MI, Dressler's

Question 2

Clinical features acute pericarditis

Answer 2

central sharp stabbing chest pain
worse on inspiration/lying flat
relief: sitting forward
sign: pericardial friction rub
fever: may occur

Question 3

Acute pericarditis complications

Answer 3

pericardial effusion

chronic pericarditis

Question 4

Tests for pericarditis

Answer 4

ECG: ST elevation
Bloods: FBC, ESR, U&E, cardiac enzymes (troponin may be raised)
CXR: cardiomegaly - may indicate pericardial effusion
Echo: if suspected pericardial effusion

Question 5

Pericarditis ST elevation

Answer 5

Happy/concave/saddle-shaped

Question 6

Tx pericarditis

Answer 6

analgesia
treat CAUSE
steroids may increase risk of reoccurrence

Question 7

What is pericardial effusion?

Answer 7

Accumulation of fluid in the pericardial sac

Caused by any cause of pericarditis

Question 8

What does echo show in pericardial effusion?

Answer 8

an echo-free zone surrounding the heart

Question 9

what is cardiac tamponade also known as?

Answer 9

pericardial tamponade

Question 10

what is cardiac tamponade

Answer 10

When an accumulation of pericardial fluid raises intrapericardial pressure, hence poor ventricular filling and a fall in cardiac output

Question 11

presentation of cardiac tamponade

Answer 11

increased pulse, decreased BP, pulses paradox, JVP up

Question 12

Becks triad for cardiac tamponade

Answer 12

falling BP, rising JVP, muffled heart sounds

Question 13

Tx for pericardial tamponade or pericardial effusion?

Answer 13

pericardiocentesis
send fluid for culture

and treat the cause!!