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21 Cards in this Set
- Front
- Back
- 3rd side (hint)
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defintition of pericarditis |
Inflammation, infection or infiltration of pericardial sac, with or without pleural effusion |
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Name 2 dangerous complications of pericarditis |
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what are the symptoms of pericarditis? |
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Signs of pericarditis? |
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What is the triad of signs for cardiac tamponade? |
Beck's triad (uncommon) 1. Muffled heart sounds 2. Distended neck veins 3. Hypotension |
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what are the 3 most relevant lab tests for pericarditis? |
1. FBC --> look for high WBC 2. ESR and CRP are raised 3. Cardiac enzyme level raised |
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What ECG findings are there in pericarditis? |
1. Diffuse ST elevation 2. followed by normalization and T-wave inversions later on |
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Describe the general management of pericarditis |
1. stabilize ABCs and resuscitation 2. Relevant investigations 3. Refer to cardio for U/S, urgent referral if tamponade suspected 4. U/S guided pericardiocentesis if hemodynamically unstable 5. Drug therapy 6. Specific treatment to target the cause |
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What are the drug therapies for pericarditis? |
1.NSAIDs: Ibuprofen 400-800mg PO q6-8h OR Aspirin 800mg q6-8h 2. Colchicine: 0.5-1mg/day in addition to NSAIDs 3. Steroids: Prednisolone 1mg/kg/day only if refractory to NSAIDs and colchicine or other reasons |
Colchicine helps by preventing recurrence of viral and idiopathic pericarditis |
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When to start a patient with pericarditis on prednisolone? |
1. refractory to NSAIDs and colchicine 2. Uremic pericarditis 3. immune-mediated pericarditis 4. connective tissue disease |
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what are the causes of pericarditis? |
1. Infective 2. Neoplastic infiltration (Lung, Breast, Lymphoma, Leukemia) 3. Systemic diseases (Pancreatitis, Uremia, Autoimmune, CTD disorders) 4. Post-irradiation |
Others: Dressler's syndrome |
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what is Dressler's syndrome? |
Dressler's syndrome is a type of pericarditis, due to an immune system response after damage to heart tissue or to the pericardium, usually after AMI |
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definition of Myocarditis ? |
inflammation of the heart, characterized by myocyte necrosis, cardiac dysfunction, heart failure |
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What are the 3 relevant lab investigations? |
1. FBC --> WBC raised in 25% 2. ESR raised in 60% 3. Cardiac enzymes elevated in minority of patients |
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Symptoms of myocarditis? |
1. Half of the patients will report a preceding viral illness 2. Other non-specific symptoms including: chest pain, dyspnea, palpitations, malaise and fatigue, fever |
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Signs of myocarditis? |
1. Tachycardia disproportionate to fever 2. Cyanosis 3. Pericardial rub (Maybe) 4. Fever and tachypnea |
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Complications of myocarditis? |
1. Heart failure 2. Cardiogenic shock and sudden cardiac death if very acute and progressive |
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ECG findings for myocarditis? |
Sinus tachycardia most common non specific ST and T wave changes, heart blocks, dysrhythmias |
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General management for myocarditis? |
1. ABC and resuscitate 2. Investigations 3. Manage patient as per acute heart failure 4. treat dysrhythmia/heart blocks if present 5. Urgent echo (Cardio referral) 6. Drug therapy |
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What drugs are used for myocarditis? |
1. ACE-I: Captopril 6.25-50 mg PO, TDS 2. Digoxin: 0.125-0.375 mg PO, once daily 3. Frusemide: 20-80 mg PO/IV BD/TDS, titrate 4. IVIG 2g/kg if viral aetiology 5. Immuno-suppressive therapy? |
mainly to provide stable rhythm+diuresis and reduce effort of the heart/myocytes |
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what drugs are contraindicated in myocarditis? why? |
NSAIDs, sympathomimetics and beta-blockers will increase myocardial necrosis |
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