Pericarditis Flashcards
Causes
Idiopathic Infective Uremic (renal failure) Neoplastic Connective tissue disease Immune disease Post MI Post cardiac surgery Dressler Syndrome
What is dressler’s syndrome?
Pericarditis 2-10 weeks post MI
Signs and symptoms
Pleuritic sharp central CP
Fever/flu if viral
Pericardial rub heard (like someone walking on snow)
Signs of tamponade
What connective disorders can cause pericarditis?
Sarcoid, SLE, scleroderma
What would you see on ECG?
Widespread saddle shaped S elevation
PR prolongation
Infective causes
Pneumococcal, TB<
Coxsackie B, Herpes, Staph
When might pericarditis arise post MI?
24-72hrs
At what time frame do you call in Dressler syndrome?
2*10 weeks
What makes it better?
Sitting forward
Name some complications of pericarditis
Cardiac Tamponade Hepatomegaly secondary to RHF Peripheral oedema (Chronic effusive pericarditis) Restrictive pericarditis Chronic heart failure
Investigations for cardiac tamponade?
Echo cardiogram - shows fluid and the heart swings
If a patient comes in with chest pain after a cold, what could they have?
pericarditis
ECG findings for pericarditis
Fake ST elevation (below J line), also known as ‘saddle shaped’
What might be elevated in pericarditis and why?
Troponin - might be due to myopericarditis or because someone had a silent MI a few days previously
Myocarditis vs pericarditis
Myocarditis - inflammation of the heart muscle
Pericarditis - inflammation of the surrounding tissue
Why do you do an echo?
To check for pericardial effusion
Note: if this is severe enough to affect the heart, it is called cardiac tamponade
Treatment of choice for pericarditis
NSAIDS
What would be elevated in cardiac tamponade?
JVP would be raised to angle of jaw
Most common cause of pericarditis
Viral
How accurate are ECG findings in pericarditis?
ECG findings are non-specific and may be normal in about 10%
What is the recurrence rate of pericarditis?
Acute pericarditis may recur in up to 30% of patients
How do you perform pericardiocentesis?
In pericardiocentesis, the needle is inserted subcostally in the midline aiming towards the left shoulder.
Investigations for pericarditis
Serial ECGs
Repeat cardiac enzymes (to exclude MI)
Echo potentially
Epidemiology
Young person
Differentials for saddle shaped ST elevation
STEMI can also cause saddle shaped MI
