Pericarditis

Question 1

What might a patient’s HPI include when suffering from pericarditis?

Answer 1

Prodrome, fever, malaise, myalgias
Acute, sharp, stabbing chest pain
Pain improved when leaning forward, worsened by lying supine
Duration of hours to days
Pleuritic pain

Question 2

What are some exam findings suggestive of pericarditis?

Answer 2

Pericardial friction rub

New widespread ST elevation or PR depression on EKG

Question 3

Where is a pericardial friction rub best heard?

Answer 3

with the diaphragm over the left sternal boarder

Question 4

What percentage of pericarditis cases present with chest pain?

Answer 4

95%

Question 5

How many stages of EKG changes might be seen with pericarditis?

Answer 5

four

Question 6

What stage of EKG change is characterized by diffuse ST elevation?

Answer 6

Stage 1

Question 7

What stage of EKG change is characterized by development of T-wave inversions?

Answer 7

Stage 3

Question 8

What percentage of pericarditis patients may show up with atypical ECG changes?

Answer 8

40%

Question 9

How does the ST segment in an ECG differ in morphology in pericarditis vs STEMI?

Answer 9

Pericarditis - ST elevation begins at the J point, rarely exceeds 5mm, normal concavity
STEMI - convex ST elevation may be more than 5mm in hight

Question 10

How does distribution in an ECG differ in pericarditis vs STEMI?

Answer 10

Pericarditis - ST changes more generalized

STEMI - localized to vascular area of infarct

Question 11

What are some differential diagnosis for pericarditis?

Answer 11

Acute MI
Pneumonia with pleurisy
Pulmonary embolism
Aortic dissection
Pneumothorax
Cholecystitis 
Pancreatitis 
Esophageal inflammation