Pericarditis Flashcards
What is pericarditis
Inflammation of the pericaridum (Fibroelastic sac around the heart)
What can cause Pericarditis
Idiopathic Coxsackie virus SLE/Sjrogens/RA Dressler's (Post MI) TB
What are the clinical features of Pericarditis
Sharp Chest pain( worse laying, better leaning forward) Fever Pericardial friction rub Raised Troponin RHF signs
What are the ECG features of Pericarditis
Wide Saddle ST Elevation
PR Depression
Can become normal after 8 weeks
How would you investigate Pericarditis
ECG - Saddle ST Elevation w/ PR depression
Raised ESR and Troponin
CXR = Water bottle shape (Pneumonia by TB)
Echo - Fluid
Angiogram - Normal Coronaries exclude MI
Which investigation excludes MI from the patient
If the Angiogram shows normal coronary arteries
What is the first line management for pericarditis (Viral/Idiopathic)
Restrict exercise and NSAIDS
Colchicine as adjunct (avoid renal patients)
What is the management of a patient unresponsive or can’t take NSAIDs for pericarditis or in non viral cases
Corticosteroids (non viral)
What is the managemnet for bacterial pericarditis cases
RIPE Abx
Pericardiocentesis if exudate present
Can use pericardiectomy if recurrent
When should you use Pericardiocentesis in Periarditis
If there is pleuritic exudate present
What are some complications of Pericarditis
Cardiac Tamponade by Pericardial Effusion
Myocarditis
Dressler’s
What is the pathology of Pericarditis
Pericardial space narrowed by inflammation
Pericardial layers rub against each other
More Inflammation occurs
This can be dry or wet effusive
What are the two types of effusion caused by pericarditis
Dry Fibrous
Wet Exudate/haemmorhagenic
Why may a patient present with SOB, tachycardia and Peripheral oedema
RHF causing Constrictive Pericarditis
- Formation of granulation tissue in Pericardium
- Impaired diastolic filling = RHF
