Pericarditis Flashcards
Pericarditis
Inflammation of the pericardial sac
Myopericarditis
Pericarditis +myopericardial inflammation (myocarditis) with normal ventricular function
Perimyocarditis
Pericarditis + myocardial inflammation (myocarditis) with reduced ventricular function
Acute Pericarditis:
Subacute Pericarditis
Chronic Pericarditis
within days
weeks to months
persists more than 6 months
Pericarditis Causes:
VINDICATE
vascular infection/inflammation neoplasms drugs. degenerative iatrogenic, idiopathic congenital/inherited/developmental autoimmune/allergy/anatomic trauma endocrine/metabolic, environmental
Viral Infections that cause Pericarditis:
coxsackie virus
adenovirus
epstein barr virus
influenza
Bacterial Infections that cause pericarditis
mycobacterium tuberculosis
staph, strep
Fungal Infection causes
Fungal:
histoplasmosis, aspergillum, blastomyces
Parasitic:
echonococcus, amoebic, toxoplasma
Other;
infective endocarditis
Rheumatologic Etiologies
SLE
RA
Systemic Sclerosis
Trauma etiologies
blunt trauma
heart surgery
post myocardial infarction
Medications
Procainamide
Hydrasalazine
Warfarin
Drug-Induced Lupus
SHIPPE-E
Sulfa drugs hydralazine isoniazid procainamide Phenytoin Etanercept
Malignancy
lung or breast cancer
Hodgkin’s disease
leukemia
melanoma
What is in EKG in acute pericarditis?
it is diffuse ST elevation
Initial Diagnostic Testing
Echocardiogram –> ultrasound of the heart
chest x ray
Initial lab counts:
- c reactive protein
- ESR
- CBC
- CMP
- Troponin I and T
2ndary Lab testing:
Blood cultures Pericardiocentesis Pericardial Biopsy Autoimmune work up: ANA RF: rheumatoid factor HIV serology PPD or Quantiferon Gold Thyroid Hormone
2ndary Diagnostic Testing
CT/infrequently needed
1ST line treatment
NSAID + colcichine
NSAIDs:
ASA (, Ibuprofen, indomethacin
2nd line treatment
glucocorticoids + colchicine
Other treatments
- therapeutic pericardiocentesis
2. surgery
Dressler Syndrome:
immune mediated pericarditis that occurs after MI
Time Frame: 2-6 weeks after myocardial infarction
Treatment: acetylsalicylic acid + colchicine
Peri-infarction pericarditis
Definition: fibrinous exudate
Time frame: 1-3 days
Pericardial Effusion:
can lead through electrical alterans
Complications of pericardial effusion
Cardiac Tamponade
Pulsus Paradoxus
large decrease in systolic blood pressure (>10 mmhg on inspiration)
Constructive pericarditis
sac like covering of the heart becomes thickened and scarred
