Pericarditis Flashcards
Common causes pericarditis?
idiopathic, viral
infection (TB, HIV, coxsackievirus Epstein Barr virus)
Autoimmune/inflammatory SLE, RA
injury after MI open heart surgery
cancer
uraemia (due to renal impairment)
medications Methotrexate
hypothyroidism
what does pericarditis present with?
fever, chest pain
how is pericarditis treated?
NSAIDs
pericardial tamponade?
pericardial effusion is large enough to raise the intracardial pressure, which squeezes on the heart- reduces filling during diastole reduces cardiac output during systole
chest pain in pericarditis?
sharp, central/anterior, pleuritis, worse lying down better sitting forward
what is key sign of pericarditis?
pericardial friction rub, scratching sound alongside heart sounds
investigations for pericarditis?
Raised CRP/ESR/ WBC
saddle shaped ST elevation on ECG
PR depression widespread
how do you diagnose pericardial effusion?
transthoracic echocardiogram
management of pericarditis?
NSAIDs
colchicine (long term 3 months to reduce recurrence)
2nd line steroids- inflammatory conditions/ recurrent cases
pericardiocentesis- to remove fluid if causing tamponade or significant pericardial effusion
how long does pericarditis last?
4-6 weeks
if you get pericarditis 1-3 days after an MI then it is?
fibrinous pericarditis
other symptoms of pericarditis?
non productive cough, dyspnoea, flu like symptoms
what does elevated troponin in pericarditis suggest?
myopericarditis
when should patients with pericarditis be managed inatient?
fever above 38, elevated troponin
what to avoid in pericarditis?
streuous activity unit inflammatory markers normalise, symptom resolution
