Pericarditis Flashcards
What is pericarditis?
Pericarditis is inflammation of the pericardium, the fibrous sac surrounding the heart.
What are the common causes of pericarditis?
Viral infections, bacterial infections, myocardial infarction, autoimmune diseases, uraemia, and malignancy.
What is Dressler’s syndrome?
Dressler’s syndrome is a form of pericarditis that occurs weeks after a myocardial infarction, thought to be autoimmune in origin.
What are the classic symptoms of pericarditis?
Pleuritic chest pain (worse on inspiration and lying down, relieved by sitting up), fever, and fatigue.
What is the characteristic feature of pericarditis chest pain?
It is sharp, pleuritic, and often relieved by sitting forward.
What are the signs of pericarditis on physical examination?
Pericardial friction rub, tachycardia, fever, and reduced heart sounds in complicated cases.
What is the pathophysiology of pericarditis?
Inflammation of the pericardium leads to increased vascular permeability, fibrin deposition, and sometimes pericardial effusion.
What are the risk factors for pericarditis?
Recent viral infection, autoimmune disease, recent surgery, malignancy, and uraemia.
What investigations are used to diagnose pericarditis?
ECG, echocardiography, chest X-ray, blood tests (e.g., inflammatory markers, troponin), and pericardial fluid analysis if needed.
What are the characteristic ECG changes in pericarditis?
Widespread ST elevation with PR depression in acute pericarditis.
What is the role of echocardiography in pericarditis?
It assesses for pericardial effusion and cardiac tamponade.
What are the complications of pericarditis?
Pericardial effusion, cardiac tamponade, and constrictive pericarditis.
What is cardiac tamponade, and how is it related to pericarditis?
Cardiac tamponade is the compression of the heart by a large pericardial effusion, impairing diastolic filling and cardiac output.
What is the treatment for viral pericarditis?
Non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine to reduce inflammation.
When are corticosteroids used in pericarditis?
Corticosteroids are reserved for severe or refractory cases or when the cause is autoimmune.
What lifestyle advice should be given to patients with pericarditis?
Rest, avoid strenuous activity until symptoms resolve, and ensure good hydration.
How is pericardial effusion detected clinically?
Clinical signs include muffled heart sounds, distended neck veins, and hypotension if tamponade develops.
What is the Beck’s triad, and how is it related to pericarditis?
Beck’s triad (hypotension, distended neck veins, muffled heart sounds) is a classic sign of cardiac tamponade.
What is the role of pericardiocentesis in pericarditis?
Pericardiocentesis is performed to drain large pericardial effusions, particularly in tamponade, or for diagnostic purposes.
What is constrictive pericarditis?
A chronic condition where the pericardium becomes thickened and fibrotic, restricting diastolic filling of the heart.
What are the common causes of constrictive pericarditis?
Recurrent pericarditis, tuberculosis, radiation therapy, and cardiac surgery.
What is the difference between pericarditis and myocardial infarction on ECG?
Pericarditis shows widespread ST elevation without reciprocal changes, while myocardial infarction typically has localised changes with reciprocal depression.
What blood tests are typically abnormal in pericarditis?
Elevated inflammatory markers (CRP, ESR) and, occasionally, elevated troponin if there is myocardial involvement.
Why is prompt treatment of bacterial pericarditis important?
Untreated bacterial pericarditis can rapidly progress to life-threatening complications like tamponade or sepsis.
What is the prognosis for pericarditis?
Prognosis is generally good for viral pericarditis with appropriate treatment, but recurrent or complicated cases may require long-term management.
