Pericarditis

Question 1

Presentation/symptoms of pericarditis?

Answer 1

• Sharp, constant sternal pain relieved by sitting forward
• Pain may radiate to the L shoulder/arm/abdomen
• Pain worse on inspiration, swallowing or coughing

Other symptoms:
* low grade Fever
* Cough
* Pain in joint (arthralgia)

Question 2

Signs of pericarditis?

Answer 2

• Pericardial friction rub (high pitched scratching sound- best heard over L sternal border during inspiration)

Question 3

What is paricardial effusion?

Answer 3

When the potential space of the pericardial cavity fills with fluid- creates presure on heart and make it more difficult to expand.

Question 4

What is cardiac tamponade and signs of it?

Answer 4

Pericardial effusion is large enough to raise intra-pericardial pressure which squeezes heart and
Affects ablity to function

Decreases cardiac output during systole- requires drainage

Signs:
* Pulsus paradoxus- decrease in palpable pulse and arterial systolic presure of 10mmHg on inspiration
* Hypotension
* Muffled heart sounds
* Jugular venous distention

Question 5

ECG changes in pericarditis?

Answer 5

Saddle shaped ST elevation
PR depression

Question 6

Management of pericarditis?

Answer 6

Treat underlying cause
NSAIDs and colchicine= 1st line treatment for viral or idopathic pericarditis

Question 7

Causes of pericarditis?

Answer 7

• Viral infection (Coxsackie)
• TB
• Uraemia
• Post MI
• Radiotherapy
• Hypothyrodism
• Cancer- lung and breast
• Trauma