Pericarditis

Front 1

What is pericarditis

Back 1

Inflammation of the pericardium that surrounds the heart. the increase in fluid within the pericardium causes pressure on the heart as it contracts and relaxes due to the inelastic fibrous pericardium layer leading to decreased cardiac output.

Front 2

Pericarditis pHx

Back 2

Result of another disorder such as infection (bacterial, viral, fungal, parasitic), trauma or surgery; neoplasm or a metabolic, immunologic or vascular disorder (uraemia, rheumatoid arthritis).

Front 3

Pericarditis classifications (2)

Back 3

1. Acute
2. Restrictive

Front 4

Layers of the pericardium (2)

Back 4

1. Serous pericardium (inner layer consisting of parietal pericardium which adheres to the inside of the fibrous pericardium and visceral pericardium which adheres to the surface of the heart).
2. Fibrous pericardium (the outermost layer/sac which consists of touch fibrous tissue which surrounds the heart and adheres to great vessels).

Front 5

Location of pericardial sac

Back 5

between the visceral and parietal layer of the serous pericardium and contains a small amount of pericardial fluid to lubricate the layers during the cardiac cycle

Front 6

Pericarditis exudate (4)

Back 6

1. blood
2. serous fluid
3. fibrous content
4. inflammatory cells/ pus

Front 7

Acute pericarditis S & S (4)

Back 7

1. sudden onset of severe chest pain that worsens with respiratory movement and lying down. pain may radiate to the back and is genrally felt in the anterior of the chest and may be confused with AMI.
3. Pt Hx of recent infection.
4. Dysphagia, restlessness, irritability, anxiety, weaknss and malaise.

Front 8

Physical Ax may disclose (4)

Back 8

1. low grade fever
2. sinus tachycardia
3. Friction rub
4. ECG changes - global ST segment elevation in most leads

Front 9

Pericarditis ECG changes

Back 9

1. Diffuse ST elevation
2. aVR = normal or slightly depressed ST
3. May be difficult to distinguish from MI if local
4. ST returns to normal on resolution of condition
5. PR and ST point in opposite directions.
6. T waves elevated in acute phase

Front 10

Restrictive (chronic) Pericarditis path

Back 10

radiation exposure, rheumatoid arthritis, uraemia or coronary bypass graft surgery (CABGS). fibrous scarring and lesions encase heart in a fibrous cell leading to a gradual decrease in cardiac output

Front 11

Restrived S & S

Back 11

Exercise intolerance

Dyspnoea on exertion

Fatigue

Anorexia
Similar ECG changes to acute with AF and T wave inversion

Front 12

Pericarditis Rx

Back 12

1. Mx pain
2. Position sitting up, legs dependant leaning forward
3. Tx