Pericarditis Flashcards
What is pericarditis?
It is defined as a condition in which there is inflammation of the pericardium, the fibrous sac which surrounds the heart
What are the nine risk factors associated with pericarditis?
Male Gender
Middle Aged 40 – 60 Years Old
Bacterial/Viral/Fungal Infection
Connective Tissue Disorders
Hypothyroidism
Post Myocardial Infarction
Uraemia
Malignancy
Drug Administration
What is the most common risk factor associated with pericarditis?
Bacterial/Viral/Fungal Infection
Which bacterial infection is associated with pericarditis?
Staphylococcus tuberculosis
What viral infection is associated with pericarditis?
Coxsackievirus
Which fungal infection is associated with pericarditis?
Histoplasmosis
What two connective tissue disorders are associated with pericarditis?
Rheumatoid arthritis
Systemic lupus erythematosus
Which two malignancies are associated with pericarditis?
Lung cancer
Breast cancer
Which drug is associated with pericarditis?
Hydralazine
What are the eight clinical features of pericarditis?
Pleuritic Chest Pain
Dry Cough
Dyspnoea
Pericardial Rub
Pericardial Effusion Features
Cardiac Tamponade Features
Tachycardia
Tachypnoea
What is pleuritic chest pain?
It is pain which is exacerbated by deep inspiration and when lying down
However, it is relieved by sitting forwards
What are the two other features of the chest pain associated with pericarditis?
Retrosternal
The pain radiates to the neck, shoulder, arms and trapezius
How do we assess for a pericardial rub?
It is loudest at the left lower sternal border
It is easiest to hear when the patient leans forward
What are the three features of a pericardial effusion?
Soft heart sounds
Tubular breath sounds in the left axilla/lung base
Obscured apex beat
What are the three features of cardiac tamponade?
Hypotension
Muffled heart sounds
Raised JVP
What three investigations are used to diagnose pericarditis?
Blood Tests
ECG Scan
ECHO Scan
How are blood test results used to diagnose pericarditis?
There is no single diagnostic laboratory test for pericarditis
However, blood tests can be used to exclude other causes or indicate the underlying aetiology
What four blood test results indicate pericarditis?
Increased WCC Levels
Increased CRP Levels
Increased ESR Levels
Increased Troponin Levels
What does an elevated troponin level in pericarditis indicate?
Myopericarditis
What is the gold standard investigation used to diagnose pericarditis?
ECG scan
What are the three features of pericarditis on ECG scans?
Global Saddle-Shaped ST Elevation
Global PR Depression
Low Voltage QRS Complexes
How are ECHO scans used to diagnose pericarditis?
They should be conducted in all patients with suspected pericarditis, in order to assess for development of pericardial effusion
What type of ECHO scan is preferred to investigate pericarditis - transoesophageal or transthoracic?
Transthoracic
Where can pericarditis patients usually be managed?
Community
What two features would indicate admission of pericarditis patients?
Fever > 38°C
Elevated troponin
What are the two conservative management options of pericarditis?
Treat Underlying Aetiology
Physical Activity Restriction
What are the three pharmacological management options of pericarditis?
Non-Steroidal Anti-Inflammatories
Colchicine
Corticosteroids
When are NSAIDs used to manage pericarditis?
They are the first line pharmacological management option
Name three NSAIDs used to manage pericarditis
Ibuprofen
Aspirin
Naproxen
What is the mechanism of action of colchicine?
Anti-inflammatory
When is colchicine used to manage pericarditis?
They are the first line pharmacological management option when administered in combination with NSAIDs
When are corticosteroids used to manage pericarditis?
They are the second line pharmacological management option
What are the four complications of pericarditis?
Chronic Pericarditis
Constrictive Pericarditis
Pericardial Effusion
Cardiac Tamponade
