Pericarditis

Question 1

Definition of Pericarditis

Answer 1

• Inflammation of the pericardium

Question 2

Aetiology of Pericarditis

Answer 2

• Viral (coxsackie, flu, EBV, HIV)
• Bacterial (pneumonia, rheumatic fever, TB, staphs)
• Fungi
• MI, Dressler’s
• Drugs (penicillin, isoniazid, procainamide, hydralazine)
• Other (uraemia, RA, SLE, sarcoid, radiotherapy)

Question 3

Signs and Symptoms of Pericarditis

Answer 3

• Signs/symptoms include central/retrosternal chest pain (sharp, pleuritic, worse lying down, relieved by sitting forward, radiates to left shoulder), pericardial friction rub, fever and signs of effusion/tamponade.

Question 4

Investigation of Pericarditis

Answer 4

• ECG
  
  • Saddle-shaped ST-elevation +/- PR depression
• Troponin
  
  • May be positive
• Cultures
  
  • Positive

Question 5

Management of Pericarditis

Answer 5

• NSAIDs
• PPIs (due to high doses of NSAIDs)
• Colchicine (improves response and decreases recurrence)
• Pericardiocentesis for tamponade
• Systemic antibiotics for infection