Acute Pericarditis:
Acute inflammation of the pericardium
–may cause pericardial effusion
Define pericarditis
Inflammation of the pericardium
Pericarditis characteristics/ sx&sxs
CP
Pericardial friction rub
referred pain to traps, neck, left shoulder
Leaning forward on exam, better if sitting up
low grade fever
dyspnea- hurts to take a deep breath
Describe a friction rub
washing machine like murmur
What EKG changes make you think pericarditis
Defuse ST elevation- all leads
also PR depression
Classic story for pericarditis
Post viral infection 1 week prior
Concerning complications
cardiac tamponade or pericardial effusion
What life threatening conditions must you rule out
MI and aortic dissection
Treatment?
High dose aspirin until no longer symptomatic, NSAIDs- ibuprofen. Colchicine for 3 months, prednisone
If there is a pericardial effusion what is the treatment?
pericardiocentesis
Serous pericarditis:
non-infectious etiology (i.e. Rheumatoid Arthritis, SLE)
If fibrin adhesion occurs–> fibrinous or serofibrinous (ex-post MI)
P’s of Pericarditis:
persistent, pleuritic, postural pain, and pericardial friction rub
Etiologies:
- *Viral MC cause (esp enteroviruses: coxsackie and echovirus), adenovirus
- Idiopathic, neoplastic, Dressler’s syndrome( pericarditis s/p MI), autoimmune, systemic, uremia, bacterial, XRT,
- Drugs (procainamide, INH, hydralazine)
Pericarditis: clinical manifestations
- Chest Pain: Pleuritic (sharp and worse with inspiration
