Pericarditis

Question 1

What is acute pericarditis?

Answer 1

inflammation of the pericardium

Question 2

What are the causes of acute pericarditis?

Answer 2

idiopathic or secondary to: viruses: EBV, mumps
Bacteria: TB
Fungi and parasitic: rare usually immunocompromised
Autoimmune: SLE, vasculitis
Drugs: procainamide, hydralazine
Metabolic: uraemia, hypothyroidism
other: trauma, malignancy

Question 3

What are the clinical features of acute pericarditis ?

Answer 3

central chest pain worse when lying or on inspiration, relief when sitting forward.
Pericardial friction rub can be heard

Question 4

How do we test for acute pericarditis?

Answer 4

ECG- concave ST elevation and PR depression. Blood tests: FBC, U&E, ESR, cardiac enzymes

Question 5

How do we treat acute pericarditis?

Answer 5

NSAIDS for 1-2 weeks
Colchicine 500mcg for 3 months to reduce recurrence

Question 6

What is constrictive pericarditis?

Answer 6

heart in a rigid pericardium

Question 7

What is the cause of constrictive pericarditis?

Answer 7

TB or unknown

Question 8

What are the clinical features of constrictive pericarditis?

Answer 8

raised JVP, Kussmaul’s sign, diffuse apex beat, quiet heart sounds

Question 9

How do we test for pericarditis?

Answer 9

CXR: small heart +- pericardial calcification