Pericarditis

Question 1

Pericarditis

Answer 1

inflammation of the pericardium.

Question 2

Pericardial Effusion

Answer 2

Potential space of the pericardial cavity fills with fluid, creating an inward pressure on the heart making it more difficult to expand during diastole.

Question 3

Pericardial Tamponade

Answer 3

pericardial effusion raises intrapericardial pressure. Reduces heart filling during diastole - decreasing CO during systole.

Question 4

RF

Answer 4

Prior infection - TB, HIV, Coxsackie, EBV
Autoimmune or inflammatory conditions
Injury to pericardium (Dresslers syndrome)
Cancer
Medications - methotrexate

Question 5

Presentation

Answer 5

Chest pain - Sharp, central and worse with inspiration (pleuritic). Worse on lying down and better on sitting forward.

Low grade fever.

Pericardial friction rub - scratching sound alongside heart sounds.

Question 6

Ix

Answer 6

Raised inflammatory markers - WCC, CRP, ESR
ECG - saddle shaped ST elevation and PR depression.
Echocardiogram - pericardial effusion.

Question 7

Treatment pericarditis

Answer 7

NSAIDS - Aspirin or ibuprofen
Colchicine - longer term to reduce recurrence.

Question 8

Treatment recurrent pericarditis

Answer 8

Steroids - if associated with inflammatory conditions or recurrent

Question 9

Treatment pericardial effusion

Answer 9

Pericardiocentesis

Question 10

Athelete advise for pericarditis

Answer 10

Athletes to avoid strenuous physical activity for at least 3 months until symptoms resolved and Ix are clear.

Question 11

When to treat as inpatient

Answer 11

INPATIENT: >38c fever or elevated troponin.

Question 12

Complications

Answer 12

Chronic recurrent pericarditis.