Pericarditis

Question 1

What is pericarditis?

Answer 1

Pericarditis is inflammation of the pericardium, the fibrous sac surrounding the heart.

Question 2

What are the common causes of pericarditis?

Answer 2

Viral infections, bacterial infections, myocardial infarction, autoimmune diseases, uraemia, and malignancy.

Question 3

What is Dressler’s syndrome?

Answer 3

Dressler’s syndrome is a form of pericarditis that occurs weeks after a myocardial infarction, thought to be autoimmune in origin.

Question 4

What are the classic symptoms of pericarditis?

Answer 4

Pleuritic chest pain (worse on inspiration and lying down, relieved by sitting up), fever, and fatigue.

Question 5

What is the characteristic feature of pericarditis chest pain?

Answer 5

It is sharp, pleuritic, and often relieved by sitting forward.

Question 6

What are the signs of pericarditis on physical examination?

Answer 6

Pericardial friction rub, tachycardia, fever, and reduced heart sounds in complicated cases.

Question 7

What is the pathophysiology of pericarditis?

Answer 7

Inflammation of the pericardium leads to increased vascular permeability, fibrin deposition, and sometimes pericardial effusion.

Question 8

What are the risk factors for pericarditis?

Answer 8

Recent viral infection, autoimmune disease, recent surgery, malignancy, and uraemia.

Question 9

What investigations are used to diagnose pericarditis?

Answer 9

ECG, echocardiography, chest X-ray, blood tests (e.g., inflammatory markers, troponin), and pericardial fluid analysis if needed.

Question 10

What are the characteristic ECG changes in pericarditis?

Answer 10

Widespread ST elevation with PR depression in acute pericarditis.

Question 11

What is the role of echocardiography in pericarditis?

Answer 11

It assesses for pericardial effusion and cardiac tamponade.

Question 12

What are the complications of pericarditis?

Answer 12

Pericardial effusion, cardiac tamponade, and constrictive pericarditis.

Question 13

What is cardiac tamponade, and how is it related to pericarditis?

Answer 13

Cardiac tamponade is the compression of the heart by a large pericardial effusion, impairing diastolic filling and cardiac output.

Question 14

What is the treatment for viral pericarditis?

Answer 14

Non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine to reduce inflammation.

Question 15

When are corticosteroids used in pericarditis?

Answer 15

Corticosteroids are reserved for severe or refractory cases or when the cause is autoimmune.

Question 16

What lifestyle advice should be given to patients with pericarditis?

Answer 16

Rest, avoid strenuous activity until symptoms resolve, and ensure good hydration.

Question 17

How is pericardial effusion detected clinically?

Answer 17

Clinical signs include muffled heart sounds, distended neck veins, and hypotension if tamponade develops.

Question 18

What is the Beck’s triad, and how is it related to pericarditis?

Answer 18

Beck’s triad (hypotension, distended neck veins, muffled heart sounds) is a classic sign of cardiac tamponade.

Question 19

What is the role of pericardiocentesis in pericarditis?

Answer 19

Pericardiocentesis is performed to drain large pericardial effusions, particularly in tamponade, or for diagnostic purposes.

Question 20

What is constrictive pericarditis?

Answer 20

A chronic condition where the pericardium becomes thickened and fibrotic, restricting diastolic filling of the heart.

Question 21

What are the common causes of constrictive pericarditis?

Answer 21

Recurrent pericarditis, tuberculosis, radiation therapy, and cardiac surgery.

Question 22

What is the difference between pericarditis and myocardial infarction on ECG?

Answer 22

Pericarditis shows widespread ST elevation without reciprocal changes, while myocardial infarction typically has localised changes with reciprocal depression.

Question 23

What blood tests are typically abnormal in pericarditis?

Answer 23

Elevated inflammatory markers (CRP, ESR) and, occasionally, elevated troponin if there is myocardial involvement.

Question 24

Why is prompt treatment of bacterial pericarditis important?

Answer 24

Untreated bacterial pericarditis can rapidly progress to life-threatening complications like tamponade or sepsis.

Question 25

What is the prognosis for pericarditis?

Answer 25

Prognosis is generally good for viral pericarditis with appropriate treatment, but recurrent or complicated cases may require long-term management.