Pericarditis Flashcards
Infective cause of pericarditis
Commonly - Coxsackie virus
Clinical Features
Pleural Chest Pain - relieved by leaning forward and worsened by lying down
Non productive cough
Auscultation: Pericardial Rub (scratchy noise)
Fever
Other causes of pericarditis
Cardiac - post MI
Rheum - RA, SLE, vasculitides
Investigations
ECG - saddle shaped ST elevation, PR depression
Echocardiogram - inflammation of pericardium
Bloods - raised troponin (due to pericarditis causing inflammation in neighbouring myocardium)
Management for acute pericarditis
Treat underlying cause
Infective / Idiopathic:
NSAIDS (and then corticosteroids if this does not work)
Restricted exercise
Constrictive Pericarditis
What is it?
Where the pericardium actually scars
Constrictive Pericarditis
Causes
Any cause of pericarditis
Particularly TB
Constrictive Pericarditis
Clinical Features
JVP - X and Y present
Kussmaul sign - paradoxical rise in JVP on inspiration
Constrictive Pericarditis
Management
Pericardiectomy
TB constrictive pericarditis usually responds to medical treatment
Cardiac Tamponade
What is it?
Build up of fluid (effusion) in the pericardium under pressure
Cardiac Tamponade
Clinical Features
Becks Triad
Hypotension
Raised JVP
Muffled heart sounds
JVP: absent Y descent
Pulses Paradoxicus - abnormal drop in blood pressure on inspiration
[at a BECK concert, with beck on a RAISED jvPlatform causes fan girls to faint (HYPOTENSION) whilst the dads are at the back wishing they weren’t there with earMUFFs on and holding their daughter’s TAMPAX]
Cardiac Tamponade
Investigations
ECG - electrical alternans
Cardiac Tamponade
Management
Urgent pericardectomy
