Pericarditis

Question 1

What is pericarditis?

Answer 1

Inflammation of the pericardium that may be acute or chronic

Question 2

What is acute pericarditis?

Answer 2

Acute pericarditis: inflammation of the pericardium that either occurs as an isolated process or with concurrent myocarditis (myopericarditis)

Question 3

What is chronic pericarditis?

Answer 3

Inflammation of the pericardium that lasts > 3 months

Question 4

What are the causes of pericarditis?

Answer 4

(Infections) Most commonly viral (e.g., coxsackie B virus), Bacterial (e.g., Staphylococcus spp., Streptococcus spp., or M. tuberculosis), Fungal
(MI)
(Uremica) Acute / Chronic kidney failure
(Autoimmune connective tissue diseases) rheumatoid arthritis, systemic lupus, scleroderma)

Question 5

What are the clinical features of pericarditis?

Answer 5

In acute pericarditis
(Chest pain) Improves on sitting and leaning forward
(Pericardial friction rub) On auscultation
(Pericardial effusion)
In chronic pericarditis
(Symptoms of fluid overload) Jugular vein distention, ↑ jugular venous pressure, Kussmaul sign (distension of jugular vein on inspiration)
(Symptoms of reduced cardiac output)
Tachycardia, pulsus paradoxus

Question 6

How is pericarditis diagnosed?

Answer 6

Clinical 
(ECG) Diffuse ST elevations 
(Echocardiography) 
(Cardiac MRI) 
(Labs) CBC: leukocytosis, ↑ Troponin I, ↑ ESR, ↑ CRP , ↑ Creatinine kinase

Question 7

What is the treatment for pericarditis?

Answer 7

(NSAIDs) Acute pericarditis often self-limiting
(Antibiotics)
(Surgery) Pericardiocentesis (for tamponade) Pericardiectomy (complete removal of pericardium)