Pericarditis

Question 1

Causes? (8)

Answer 1

Viral infections (Coxsackie)
Bacterial infections
TB
Uraemia
Trauma
Post MI, Dresslers Syndrome 
Connective tissue disease
Hypothyroidism

Question 2

Presentation?

Answer 2

chest pain: may be pleuritic. Is often relieved by sitting forwards
other symptoms include non-productive cough, dyspnoea and flu-like symptoms
pericardial rub
tachypnoea
tachycardia

Question 3

Investigations?

Answer 3

Bloods: FBC, ESR, CRP, U&E, troponin, cultures
ECG
CXR
Echo: cardiac tamponade/pericardial effusion suspected.

Question 4

What are the ECG changes? (2)

Answer 4

Widespread ‘saddle-shaped’ ST elevation

PR depression: most specific ECG marker for pericarditis

Question 5

Initial Mx?

Answer 5

ABCDE
Analgesia - NSAIDs (opiod if needed)
Steroids (if autoimmune) e.g. prednisone

Question 6

What is the Rx if pericardial effusion present?

Answer 6

Pericardiocentesis

Question 7

What medication must be stopped and why?

Answer 7

Anticoagulants

Haemopericardium

Question 8

What is Dressler’s Syndrome?

Answer 8

Autoimmune pericarditis +/- effusion 2-14 weeks post MI