Pericarditis

By

Dr. Hanan Said Ali

LEARNING OBJECTIVES

Define pericarditis.Identify causes of pericarditis.Enumerate signs and symptoms of

disease.Explain how to diagnose the case.Discus the Principles of care.

PERICARDITIS

DefinitionPericarditis is inflammation of the pericardium

due to a variety of causes.

CausesInfection: viruses ( coxsakie, echo) or TB.Myocardial infarction: either within 1-2 days.MalignancyRadiotherapy

PERICARDITISCauses Cont.Trauma ( including cardiac surgery)UraemiaConnective tissue disorders.

Assessment ( signs & symptoms)Pain: usually presents as a sharp, constant central

chest pain eased by sitting forward and worsened by deep inspiration.

It worsened by flexion, extension, or rotation of the spine, including the neck; by movements of the shoulders and arms; by coughing; or by swallowing.

It may radiate to the neck, arm, shoulder, or occasionally abdomen.

It is not related to food nor eased by nitrates.

PERICARDITIS

Assessment ( signs & symptoms) Cont.

Auscultation: may reveal a pericardial friction rub; scratchy noise heard throughout the cardiac cycle caused by rubbing together of the inflamed surface.

Raised jugular venous pressure.

PERICARDITISPhysiological assessmentECG: classically reveals concave- upward ST

segment elevation in all leads.

Heart rate: tachycardia may be evident.

Pyrexia may be present. ( Pericardial tamponade may present with signs

of poor flow and right heart congestion, or with cardiac arrest)

PERICARDITISInvestigationsThe chest x- ray ( and echocardiograph) usually

reveals no abnormality unless a pericardial effusion or associated myocarditis is present.

Fluid in the pericardial space may be visualized by echo.

Calcification may be visible in longstanding tuberculous pericarditis.

PERICARDITIS

Principles of careBed restAnti- inflammatory agents such as indomethacin.Treatment of the cause wherever possible.Steroid are rarely indicated. Occasionally,

surgery is needed when constrictive pericarditis causes haemodynamic compromise

The patient’s temperature is monitored frequently.

Because sitting upright and leaning forward is the posture that tends to relieve pain, chair rest may be more comfortable.

As the chest pain and friction rub abate, activities of daily living may resume gradually.

If the patient is receiving medications such as analgesics, antibiotics, or corticosteroids for the pericarditis, his or her responses are monitored and recorded.