Pericarditis

• Pericarditis is the inflammation of the pericardium - the double layers sac that surrounds the heart
• Most common cause is a viral infection, also:

  • Autoimmune and inflammatory conditions
  • Injury - MI or trauma
  • Malignancy
• Pericarditis causes chest pain that is:

  • Sharp
  • Central
  • Pleuritic - worse on inspiration
  • Worse on lying down
  • Better when leaning forward
• Pericarditis also causes a low grade fever and SOB

  A pericardial rub can be heard on auscultation
• Pericarditis can lead to pericardial effusion and cardiac tamponade

  Becks triad:

  • Hypotension
  • Muffled heart sounds
  • Raised JVP
• Pericarditis will cause saddle shaped ST elevation on an ECG

  An echo can be done to identify pericardial effusion
• Management of pericarditis:

  1. NSAIDs and PPI
  2. Colchicine taken longer term to prevent reoccurrence
  3. Steroids only for recurrent cases or associated with inflammatory conditions
• A large effusion or cardiac tamponade requires urgent pericardiocentesis