Pericarditis

• Common causes of Pericarditis

  • Idiopathic (no underlying cause)
  • Viral
• Pericarditis treatment

  NSAIDs
• Pericardial cavity

  The potential space between the two layers of the pericardium
• Pericardial tamponade

  Large pericardial effusion raising intra-pericardial pressure, making it difficult for the heart to expand during diastole
• Symptoms of Pericarditis

  • Chest pain
  • Fever
• Pericardial effusion

  Filling of the pericardial cavity with fluid, creating inward pressure on the heart
• Pericarditis

  Inflammation of the pericardium, the membrane surrounding the heart
• Pericardium

  The membrane surrounding the heart with two layers and a small amount of fluid in between for lubrication
• Pericardial tamponade (or cardiac tamponade) is where the pericardial effusion is large enough to raise the intra-pericardial pressure, squeezing the heart and affecting its ability to function
• Pericardial tamponade is an emergency and requires prompt drainage of the pericardial effusion to relieve the pressure
• Investigations for pericarditis

  1. Blood tests show raised inflammatory markers (white blood cells, CRP, and ESR)

  2. ECG changes include saddle-shaped ST-elevation, PR depression

  3. Echocardiogram can be used to diagnose a pericardial effusion
• Chest pain in pericarditis

  • Sharp
  • Central/anterior
  • Worse with inspiration (pleuritic)
  • Worse on lying down
  • Better on sitting forward
• Speaker: 'Quote'
• Pericardial tamponade

  Reduces heart filling during diastole, decreasing cardiac output during systole
• Key presenting features of pericarditis

  • Chest pain
  • Low-grade fever
• Ricardial cavity fills with fluid, creating an inward pressure on the heart, making it more difficult to expand during diastole
• Pericardial friction rub


  • A rubbing, scratching sound that occurs alongside the heart sounds
• Management of pericarditis

  1. Non-steroidal anti-inflammatory drugs (NSAIDs) are the mainstay of treatment (e.g., aspirin or ibuprofen)

  2. Colchicine taken longer-term to reduce the risk of recurrence

  3. Steroids may be used second-line, in recurrent cases or associated with inflammatory conditions

  4. Underlying causes such as tuberculosis and renal failure should be treated appropriately

  5. Pericardiocentesis may be required to remove fluid from around the heart if there is a significant pericardial effusion or tamponade

  6. Most cases resolve within a month, but some may persist long-term, called chronic pericarditis