pericarditis Flashcards

1
Q

what is the pericardium

A

protective covering for the heart

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2
Q

what does pericardium consist of

A
  • outer fibrous pericardial sac

- inner serous pericardium

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3
Q

what does the outer pericardium line

A

the fibrous sac

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4
Q

what is normal amount of pericardial fluid

A

20-49mL

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5
Q

what does the pericardial fluid do

A

lubricate the surface of the heart

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6
Q

what is pericarditis

A

inflammation of the pericardium

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7
Q

what are most cases caused by

A

unknown

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8
Q

causes

A
  • infection e.g. TB, strep, staph, H.influenza
  • tumours
  • autoimmune
  • post-surgical
  • post-radiation
  • familial
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9
Q

what is most common viral cause

A

Coxsackie B virus

echovirus

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10
Q

how long does viral pericarditis last

A

short time

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11
Q

what is an implication

A

HIV

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12
Q

what can bacterial pericarditis occur with

A
  • septicaemia

- pneumonia

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13
Q

what is a frequent cause of bacterial pericarditis in HIV patients

A

staph aureus

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14
Q

what does TB pericarditis present with

A
  • low grade fever in evening
  • SOB
  • malaise
  • night sweats
  • weight loss
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15
Q

what is required for diagnosis of TB pericarditis

A

pericardial aspiration

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16
Q

what is an outcome of TB pericarditis

A

constrictive pericarditis

17
Q

what is treatment for TB pericarditis

A

as for pulmonary tuberculosis plus prednisolone daily for 2-3 weeks

18
Q

what is a frequent complication of endemic fungal infections

A

pericarditis

19
Q

when can pericarditis occur after MI

A

first few days following MI

20
Q

what type of MI is post-MI pericarditis common with

A
  • anterior MI
  • STEMI
    with high serum cardiac enzymes
21
Q

what is post-MI pericarditis usually a feature of

A

Dressler syndrome

22
Q

what are differential diagnosis of post-MI pericarditis

A
  • new MI

- unstable angina

23
Q

what are common causes of malignant pericarditis

A
  • carcinoma of bronchus
  • carcinoma of breast
  • Hodgkins lymphoma
24
Q

what is uraemic pericarditis due to

A

irritation of the pericardium by accumulating toxins

25
Q

how can uraemic pericarditis occur

A

in patients with advanced kidney disease if dialysis is delayed

26
Q

symptoms

A
  • sharp central chest pain that is exacerbated by movement
  • pain relieved by sitting forward
  • pain may radiate to neck or shoulder
  • pericardial friction rub
  • fever
  • SOB
27
Q

differential diagnosis

A
  • angina

- pleurisy

28
Q

what is diagnostic

A

ECG

29
Q

what is seen on ECG

A
  • saddle shaped ST elevation
  • ST depression in reciprocal leads
  • sinus tachycardia
30
Q

what else is done for investigations

A
  • cardiac enzymes elevate = myocarditis ?

- CXR = cardiomegaly ?

31
Q

treatment

A

bed rest and NSAIDs

32
Q

examples of NSAIDs

A
  • aspirin

- ibuprofen

33
Q

what is drug of choice in patient with recent MI

A

aspirin