Acute pericarditis

• What is acute pericarditis?

  Inflammation of the pericardial sac lasting less than 4-6 weeks
• What are some possible causes of acute pericarditis?

  Viral infections (Coxsackie)

  TB

  Uraemia

  Post MI

  Radiotherapy

  Connective tissue diseases

  Hypothyroidism

  Malignancy

  Trauma
• What are some clinical features of pericarditis?

  Retrosternal chest pain

  Pericardial friction rub

  Low grade fever

  Prodromal myalgia and malaise
• How do you tell the difference between pleural rub and pericardial friction rub?

  Ask patient to hold their breath
• Where is a pericardial friction rub best heard?

  Left sternal border
• How is retrosternal chest pain improved?

  Sitting up and leaning forwards
• What are some bedside tests for pericarditis?

  ECG
• What is seen on an ECG for pericarditis?

  Saddle shaped ST elevation + PR depression
• What are some bloods done for pericarditis?

  CRP

  ESR

  FBC

  Troponins

  Urea
• What could elevated serum troponins suggest?

  Myocardial involvement - myopericarditis
• What imaging is done for pericarditis?

  Echo

  CXR
• What can be seen in an echo for pericarditis?

  Pericardial effusion
• How is pericarditis managed?

  NSAIDs and colchicine for idiopathic or viral

  Treat underlying cause (if possible)
• What is first-line management for idiopathic or viral pericarditis?

  NSAIDs and colchicine
• What are some complications of pericarditis?

  Cardiac tamponade

  Pericardial effusion

  Constrictive pericarditis

  Recurrent pericarditis