Pericarditis

Question 0

Cause of acute pericarditis?

Answer 0

1. Infectious
2. Vasculitis (autoimmune, postradiation)
3. Immunologic (Dressler)
4. MI
5. Trauma
6. Neoplasms (breast, lung, lymphoma)

Question 1

Friction rub best heard where?

Answer 1

Left sternal border

Question 2

Classic description of pericarditis garnered from hx?

Answer 2

1. Substernal chest pain
2. worsens with inspiration and recumbency
3. radiates to trapezius ridge
4. improved by sitting and leaning forward

Question 3

EKG findings in acute pericarditis?

Answer 3

1. Diffuse ST segment elevation
2. PR segment depression
3. Opposite findings to above in aVR and V1

Question 4

Why is it important to distinguish between an MI and pericarditis?

Answer 4

Thrombolytics is treatment for infarction but could cause pericardial hemorrhage and cardiac tamponade if patient has pericarditis

Question 5

EKG findings seen in MI but not in pericarditis?

Answer 5

1. ST segment depression in other leads
2. Loss of R wave amplitude
3. Q waves

Question 6

Symptomatic differences of pain between MI and pericarditis?

Answer 6

MI – gradual onset with crescendo pattern, pressure-type pain, pain does not vary with inspiration, pain relieved with nitrates

Pericarditis – sharp pain, varies with respiration

Question 7

Treatment of acute pericarditis?

Answer 7

NSAIDs, Colchicine, steroids

Question 8

Patient with pericarditis end-stage renal disease – likely cause? Tx?

Answer 8

Uremic pericarditis. Dialysis