Perciarditis

Question 1

What is acute pericarditis?

Answer 1

Inflammation of the pericardial sac lasting for less than 4-6 weeks

Acute pericarditis can have various aetiologies and presents with specific symptoms.

Question 2

What are common viral infections that can cause acute pericarditis?

Answer 2

Coxsackie virus

Viral infections are among the etiological factors for acute pericarditis.

Question 3

Name two other aetiologies of acute pericarditis besides viral infections.

Answer 3

• Tuberculosis
• Uraemia

Other causes include post-myocardial infarction, autoimmune conditions, and malignancies.

Question 4

What is Dressler’s syndrome?

Answer 4

Autoimmune pericarditis that occurs weeks to months after myocardial infarction

It is a late complication following myocardial injury.

Question 5

What are the typical features of acute pericarditis?

Answer 5

• Chest pain (may be pleuritic)
• Non-productive cough
• Dyspnoea
• Flu-like symptoms
• Pericardial rub

Chest pain is often relieved by sitting forwards.

Question 6

What ECG changes are characteristic of pericarditis?

Answer 6

• Global/widespread changes
• Saddle-shaped ST elevation
• PR depression (most specific marker)

These changes are distinct from ischaemic events which show ‘territorial’ changes.

Question 7

What is the first line treatment for acute pericarditis?

Answer 7

NSAIDs and colchicine

Colchicine inhibits beta tubulin polymerisation and acts as an anti-mitosis drug.

Question 8

What should patients with acute pericarditis avoid until symptom resolution?

Answer 8

Strenuous physical activity

This includes athletes, who should avoid strenuous exercise for at least 3 months.

Question 9

What indicates possible myopericarditis in patients with acute pericarditis?

Answer 9

Elevated troponin levels in around 30% of patients

Elevated troponin suggests myocardial involvement.

Question 10

What are high-risk features in acute pericarditis that necessitate inpatient management?

Answer 10

• Fever > 38°C
• Elevated troponin

Patients with these features are at higher risk for complications.

Question 11

Fill in the blank: The pericardial rub is a feature of _______.

Answer 11

acute pericarditis

This sign is often detected during physical examination.

Question 12

What is the imaging in suspected acute pericarditis?

Answer 12

Transoesophageal echo in All patients with suspected acute pericarditis should undergo this investigation

It helps in assessing the pericardial effusion and other complications.

Question 13

True or False: Strenuous physical activity is encouraged during the acute phase of pericarditis.

Answer 13

False

Patients are advised to avoid strenuous activities until symptoms and inflammatory markers normalize.

Question 14

How to manage pericarditis with adhesions or recurrent tamponade?

Answer 14

Pericardiectomy

Question 15

How is pericarditis managed with bacterial origin?

Answer 15

Intravenous antibiotics

Question 16

How to manage pericarditis with haemodynamically instability?

Answer 16

Oerucarduicebtesis

Question 17

What is reccomended to prevent progression to myocarditis?

Answer 17

Exercise restriction

Question 18

What is the most specific ECG finding for acute pericarditis?

Answer 18

PR depression

Question 19

Which cancers are linked to pericarditis?

Answer 19

Throacic cavity cancer. Like breast and lung cancer

Question 20

What is the most specific ECG marker for pericarditis?

Answer 20

PR depression

Question 21

Which investigation must be done in acute pericarditis?

Answer 21

transthoracic echocardiography

Question 22

What is cardiac tamponade used for?

Answer 22

valvular abnormalities, cardiomyopathies and intracardiac tumours

Question 23

What indicates myocarditis with pericarditis?

Answer 23

respiratory symptoms of SOB along with history of viral infection and elevated cardiac enzymes like troponin