Pericarditis

Question 1

What is pericarditis?

Answer 1

Inflammation of the pericardium (with or without pericardial effusion)

Question 2

What are the infectious causes of pericarditis? (3)

Answer 2

Viral: enteroviruses (Cox B), EBV, HIV
Bacterial: TB
Fungal: rare, in immunocompromised

Question 3

What are some non-infectious causes? (5)

Answer 3

Autoimmune: SLE, RF, RA
Metastatic cancer
Iatrogenic: PCI, pacemaker
Direct trauma
Metabolic

Question 4

What are the clinical presentations of pericarditis? (5)

Answer 4

Severe pleuritic, sharp chest pain
Dyspnoea
Hiccups (phrenic nerve involvement)
Fever
Tachycardia

Question 5

What exacerbates the pain in pericarditis?

Answer 5

Worse on breathing, lying flat

Question 6

What alleviates the pain in pericarditis?

Answer 6

Sitting forward

Question 7

How would you diagnose pericarditis and what would you see?

Answer 7

ECG

• widespread saddle-shaped ST elevation
• PR depression

Question 8

What is pericardial effusion?

Answer 8

Collection of fluid in the pericardial space

Question 9

What is cardiac tamponade?

Answer 9

Reduced ventricular filling due to pericardial effusion

Question 10

What are the clinical presentations of cardiac tamponade? (3)

Answer 10

Beck’s triad

• low BP
• rising JVP
• muffled SS1 & S2 heart sounds

Question 11

How would you treat pericarditis? (4)

Answer 11

NSAIDs/ aspirin (+PPI)
Colchicine
Oral steroids
Treat underlying cause eg abx if bacterial