Pericarditis

Question 1

Define

Answer 1

Inflammation of pericardium

Question 2

Etiology

Answer 2

Viruses->Coxsackie, EBV, mumps, varicella, HIV
Bacterial->TB, RF, staph/streps
Fungi
MI->Dressler's
Uremia
RA
SLE
Myxedema
Trauma
Surgery
Malignancy
Radiotherapy
Sarcoidosis

Question 3

Clinical presentation

Answer 3

Chest pain
\++On inspiration
Releived by leaning forward
Pericardial friction rub
Look for evidence of pericardial effusion/tamponade

Question 4

Investigations and findings

Answer 4

ECG->concave ST segment
FBC
ESR/CRP
Viral serology
Blood cultures
Serum troponin
CXR
EchoC

Question 5

General management

Answer 5

NSAID->ibuprofen
Proton pump inhibitor
Colchicine if recurrent

If antibiotics required->Vancomycin + gentamicin/ceftriaxone

Question 6

Patient instructions

Answer 6

1. It is advised that vigorous exercise should not be performed until after the chest pain resolves.
2. Specific recommendations exist regarding participation in competitive sport.
3. Athletes should be temporarily excluded from all competitive and amateur sporting events until after clinical resolution (at least 3 months following clinical presentation).
4. Resumption of sports activities can occur when there is no clinical evidence of active disease and serum inflammatory markers have normalised.
5. Constrictive pericarditis excludes patients from all competitive sports.