Pericarditis Flashcards
What is pericarditis?
Pericarditis is inflammation of the pericardium, the membrane surrounding the heart. It is most commonly idiopathic (no underlying cause) or viral.
What are common causes of pericarditis?
Common causes include:
* Idiopathic (no cause)
* Viral infections (e.g., tuberculosis, HIV, coxsackievirus, Epstein–Barr virus)
* Autoimmune conditions (e.g., lupus, rheumatoid arthritis)
* Injury (e.g., after MI or surgery)
* Uraemia
* Cancer
* Medications (e.g., methotrexate)
What is the pathophysiology of pericarditis?
The pericardium has two layers with a small amount of fluid between them. Inflammation can disrupt this lubrication, causing friction and pain during heartbeats.
What is pericardial effusion?
Pericardial effusion occurs when fluid accumulates in the pericardial cavity, increasing pressure on the heart and making it harder to expand during diastole.
What is pericardial tamponade?
Pericardial tamponade is a condition where a large pericardial effusion raises intra-pericardial pressure, squeezing the heart and reducing cardiac output. It is a medical emergency requiring prompt drainage.
What are the key symptoms of pericarditis?
Key symptoms include:
* Chest pain (sharp, central, pleuritic, worse with inspiration, worse when lying down, better when sitting forward)
* Low-grade fever
What is a pericardial friction rub?
A pericardial friction rub is a rubbing or scratching sound heard on auscultation, indicating inflammation of the pericardium.
What do blood tests show in pericarditis?
Blood tests typically show raised inflammatory markers, including white blood cells, CRP, and ESR.
What are common ECG changes in pericarditis?
Common ECG changes include:
* Saddle-shaped ST-elevation
* PR depression
How is pericarditis diagnosed?
Diagnosis is made through clinical presentation, blood tests, ECG, and an echocardiogram (which can show pericardial effusion).
What is the first-line treatment for pericarditis?
First-line treatment involves NSAIDs (e.g., aspirin or ibuprofen) to reduce inflammation and pain.
When is colchicine used in the management of pericarditis?
Colchicine is used long-term (e.g., 3 months) to reduce the risk of recurrence in pericarditis.
When are steroids used in pericarditis?
Steroids are used second-line for recurrent pericarditis or when associated with inflammatory conditions like rheumatoid arthritis.
What is pericardiocentesis, and when is it required?
Pericardiocentesis is a procedure to remove fluid from around the heart and is required in cases of significant pericardial effusion or tamponade.
What is the prognosis for pericarditis?
Most cases resolve within a month. However, pericarditis can recur or persist long-term, known as chronic pericarditis.
