Pericarditis Flashcards
define pericarditis?
- it is the inflammation of the pericardium
- can be categorized as acute, subacute, or chronic
what is the epidemiology of pericarditis?
- it is uncommon
- makes up <1/100 hospital admissions
- more common in males than females
- common in late summertime
what are the risk factors of pericarditis?
- idopathic
- infective
- connective tissue disease
- post MI (common)
- Dresslers syndrome
- malignancy
- radiotherapy
- thoracic surgery
- drugs
what are the most common causative organisms?
Coxsackie B Echovirus Mumps Streptococci Staphylococci TB Fungi
what are the presenting symptoms of pericarditis?
- sharp chest pain which is worse on breathing in and relieved on sitting forwards
- dyspnoea
- nausea
Recognize the signs of pericarditis on physical examination?
- fever
- pericardial friction rub
- faint heart sounds due to pericardial effusion
where is pericardial friction rub best listened to?
- it is best heard on the lower left sternal edge with the patient leaning forward on expiration.
what are the signs of cardiac tamponade?
- Becks triad = raised JVP low BP muffled heart sounds - tachycardia - pulsus paradoxus
what is pulsus paradoxus?
it is an abnormally large decrease in SBP and pulse amplitude during INSPIRATION.
what are the best investigations for pericarditis?
- ECG
- echocardiogram
- bloods
- CXR
what will be seen on ECG?
widespread saddle-shaped ST elevation
what does the echocardiogram assess?
the extent of pericardial effusion and assesses the cardiac function
which bloods should be ordered?
- FBC
- Us and Es
- ESR/CRP
- cardiac enzymes (this is normal)
- blood cultures
what will the CXR show?
- it is usually normal
- can be globular if there is pericardial effusion.
what is the management plan for pericarditis?
- acute: cardiac tamponade is treated with emergencypericardiocentesis
- medical: treat the underlying cause
- use NSAIDs for pain and fever relief
