Pericarditis

Question 1

Most common cause of pericarditis

Answer 1

Tuberculosis

Question 2

Aetiology of pericarditis (9)

Answer 2

1. Infection
2. Myocardial infarction
3. Uraemia
4. Autoimmune
5. Trauma/surgery/radiation
6. Malignancy
7. Aortic dissection
8. Drugs
9. Idiopathic

Question 3

Dressler syndrome

• Timeline
• Percentage of patients affected
• Clinical presentation
• Pathophysiology

Answer 3

• Occurs 2-3 weeks after MI
• 7% patients affected
• Persistent low-grade fever, pleuritic chest pain, pericarditis and/or a pericardial effusion
• Autoimmune reaction to myocardial neo-antigens

Question 4

Symptoms of pericarditis (3)

Answer 4

1. Chest pain - pleuritic, retrosternal, aggravated by lying down, alleviated by sitting forward
2. Dry cough
3. Fever, fatigue and anxiety

Question 5

Signs of pericarditis (3)

Answer 5

1. Friction rub at left lower sternal border
2. Signs of tamponade (Beck’s triad, pulsus paradoxus)
3. Diaphoresis and distress

Question 6

Signs of pericarditis on ECG (3)

Answer 6

1. Widespread concave (saddle) ST elevation and PR depression (often first sign as atria are thin)
2. Reciprocal ST depression and PR elevation in avR and V1
3. Tachycardia

Question 7

Management of pericarditis

1. Mild cases
2. Severe cases
3. Specific to Dressler’s

Answer 7

1. Pain relief (aspirin or NSAIDs)
2. Pericardiocentesis, surgery
3. Colchicine - decreases risk of further episodes

STEROIDS INCREASE THE CHANCE OF RECURRENCE.