Week 4 - Pericarditis Flashcards
what is pericarditis
- inflammation of the pericardial sac/pericardium
what are causes of pericarditis (10)
- idiopathic
- bacterial
- viral
- autoimmune disease
- radiation
- post MI
- TB
- neoplasm
- drug
- trauma
what are symptoms of pericarditis (3)
- chest pain
- dyspnea
- pericardial friction rub hallmark finding
describe the chest pain during pericarditis
- progressive, frequently severe
- sharp and pleuritic in nature
what causes the chest pain in pericarditis to worsen?
- deep inspiration
- when lying supine
what relieves the chest pain in pericarditis
- sitting forward
where might the chest pain in pericarditis radiate to (4)
- neck
- arms
- left shoulder
- trapezius muscle
- difficult to differentiate from angina*
why does dyspnea occur in pericarditis
- r/t the pts need to breath in rapid, shallow breaths to avoid chest pain
what is pericardial friction rub
- scratching, grating, high-pitched sound
- arises from friction between the roughened pericardial and epicardial surfaces
- heard with stethoscope at lower left sternal border of chet
what are 2 major complications of pericarditis
- pericardial effusion
- cardiac tamponade
what is a pericardial effusion
- accumulation of excess fluid in the pericardium
what does a pericardial effusion cause?
- compression of adjoining structures (pulmonary tissue, phrenic nerve, laryngeal nerve)
list signs of pericardial effusion (6)
- cough
- dyspnea
- tachypnea
- hiccups
- hoarseness
- distant, muffled heart sounds
what is cardiac tamponade
- develops as fluid accumulates in the pericardial sac (pericardial effusion)
= increase in intrapericardial pressure and compression of the heart = decreased CO
what does cardiac tamponade cause (8)
- chest pain
- confusion
- anxiety, restless
- muffled heart sounds
- tachypnea
- tachycardia
- neck and jugular vein distension (blood cant move foward)
- dyspnea
what can be used to diagnose pericarditis (6)
- ECG
- chest xray (cardiomegaly)
- echo (pericardial effusion, cardiac tamponade)
- CT
- CMRI
- CBC (Leukocytosis, CRP, ESR)
what is included in treatment/care for a pt with pericarditis (5)
- correct underlying problem (ab if bacteria, corticosteroids if autoimmune, etc.)
- high dose anti-inflammatories
- bedrest w HOB elevated & tripod positions
- manage pain and anxiety
- pericardiocentesis
what should you monitor when giving high dose anti-inflammatories for pericarditis (2)
- GI bleeds
- may give meds to protect the GI tract and decrease gastric irritants (ex. proton pump inhibitor)
what 2 NSAIDs are often used for pain & inflammation in pericarditis
- high dose ASA
- ibuprofen
when is pericardiocentesis used in treatment of pericarditis
- if pericardial effusion w cardiac tamponade is occuring
what are interventions to avoid GI bleeds when giving high dose anti-inflammatory meds
- give the drugs w food or milk
- instruct the pt to avoid alcohol while on these meds
