Pericarditis Flashcards
Definition (& 4 types)
Acute inflammation of the pericardium
Acute pericarditis begins suddenly but doesn’t last longer than three weeks. Future episodes can occur. It may be difficult to tell the difference between acute pericarditis and pain due to a heart attack.
Recurrent pericarditis occurs about four to six weeks after an episode of acute pericarditis with no symptoms in between.
Incessant pericarditis lasts about four to six weeks but less than three months. The symptoms are continuous.
Chronic constrictive pericarditis usually develops slowly and lasts longer than three months.
Aetiology/ causes
Most common secondary to viral infection (Coxsackie B, echovirus, HIV infection) or MI
Other causes include uraemia, autoimmune rheumatic diseases, trauma, infection (bacteria, fungal, or tuberculosis) and malignancy (breast, lung, leukaemia, and lymphoma)
Risk factors
Being treated with steroids
Diabetes
Extensive burn injuries
Systemic infections
Immunosuppression
Heart surgery
Chest trauma
Pre-existing pericardial effusion
Epidemiology/ Population affected
More common in ages between 40-60
More common in males
Clinical presentation
Sharp, retrosternal chest pain which is characteristically relieved by leaning forward
Potentially worse on inspiration, coughing, or lying down, can radiate to the neck and shoulders
Pericardial friction rub: due to friction between the pericardial layers, typically loudest at the left lower sternal border, best heard with the patient leaning forward
Prognosis
Idiopathic pericarditis is typically self-limiting in 70-90% of patients.
If an underlying cause of pericarditis is found, management should involve treating the underlying condition.
For the majority of patients, the definitive treatment for chronic constrictive pericarditis is surgical pericardiectomy (resection of the pericardium)
DDX
Acute coronary syndrome
Pneumonia with pleurisy
Pulmonary embolism
Gastro-oesophageal reflux disease
Costochondritis
