Pericarditis

Question 1

Describe the EKG findings of Acute Pericarditis?

Answer 1

• Diffuse ST-elevation, which is typically Concave Upwards.

- PR depressions, usually in all limb and pre-cordial leads.

Question 2

What lead is the only lead that may have PR Elevation on EKG?

Answer 2

aVR, all others may have PR depression

Question 3

What tests/labs should be ordered for someone with suspected Pericarditis? (8 listed)

Answer 3

1) CBC
2) EKG
3) BMP
4) CRP
5) ESR
6) Echo
7) CXR
8) Troponin

Question 4

How many criteria are needed to make a pericarditis diagnosis? How many are there, and what are they?

Answer 4

1) Pleuritic Chest Pain
2) Pericardial Friction Rub
3) EKG Changes
4) Pericardial Effusion

Question 5

What is the standard treatment for Pericarditis? What if Acute Pericarditis is after an MI? What if the acute pericarditis is refractory to the initial treatment?

Answer 5

1) NSAIDs (Indomethacin,or Ibuprofen, or ASA)
+
Colchicine

If following an MI, same treatment! But typically use ASA as already being used for MI.

Refractory cases –> Tx = Colchicine + Prednisone

Question 6

What changes are seen in Pericarditis 2/2 ESRD on EKG?

Answer 6

Typical EKG changes are NOT often seen on EKG in Uremic Pericarditis

Question 7

What is preferred treatment for Pericarditis 2/2 ESRD?

Answer 7

Dialysis!

NSAIDs and Colchicine have limited benefit in uremic endocarditis. In this circumstance, you need to treat the underlying cause.

Question 8

What BUN level is associated with Uremic Pericarditis?

Answer 8

BUN > 60

(remember, this is termed azotemia.