Pericarditis

Question 1

Symptoms of Pericarditis

Answer 1

Acute, Sharp pain
Pleuritic pain: aggravated by movement, exercise and swallowing
Relieved by leaning forwards

Question 2

What can you hear on auscultation?

Answer 2

Pericardial rub

Rough scratching sound- 3 components: systolic, diastolic and atrial-systolic

Question 3

How can the pericardial rub murmur be accentuated?

Answer 3

By leaning the patient forwards

Question 4

In acute pericarditis, what does the ECG show?

Answer 4

Saddle shaped ST elevation

Widespread and generalised- all 12 leads

Question 5

In acute pericarditis, what does the x-ray show?

Answer 5

‘Pericardial effusion’- accumulation of fluid in the pericardial cavity- enlargement

Question 6

Causes of Pericarditis

Answer 6

Idiopathic
Inflammatory
Infectious
Post surgical/ trauma
Pulmonary arterial hypertension
Radiotherapy
Malignancy
Metabolic

Question 7

Inflammatory causes of Pericarditis

Answer 7

Post MI- Dressler syndrome

Connective Tissue Disorders

Question 8

Infectious causes of Pericarditis

Answer 8

Coxsackie Virus A/B
Varicella
Herpes simplex
Influenza virus
Echovirus
TB
Bacterial

Question 9

Malignant causes

Answer 9

Primary: pericardial mesothelioma
Metastatic
Lymphomas

Question 10

Metabolic causes

Answer 10

Hypothyroidism

Uraemia

Question 11

Complications of pericarditis

Answer 11

Pericardial effusion- symptoms when large

Cardiac Tamponade

Question 12

Management of Cardiac Tamponade

Answer 12

Pericardiocentesis

Question 13

What is cardiac shock?

Answer 13

Low CO
Cerebral confusion
Severe hypotension

Question 14

What causes cardiac shock?

Answer 14

Pericardial cavity fills with fluid which causes the pericardial pressure to increase above the filling pressures of the heart which prevents cardiac filling