Acute Pericarditis

Cardiology

Inflammation of pericardium.

Causes

  • Viral (Coxsackie, echovirus)
  • Post-MI (Dressler)
  • Uraemia
  • Autoimmune
  • TB, malignancy
  • Post-cardiac surgery

Clinical features

  • Sharp pleuritic chest pain worse supine, better sitting forward
  • Radiation to trapezius

Examination

  • Pericardial friction rub

Investigations

  • ECG: diffuse concave ST↑ + PR depression
  • Echo (effusion)
  • Troponin (myopericarditis if raised)
  • CRP, CBC, U&E, TFT

Management

  • Ibuprofen 600 mg TDS × 1-2 wk + PPI
  • Colchicine 0.5 mg BD (0.5 mg OD if <70 kg) × 3 months
  • Restrict exercise ≥3 months
  • Treat cause

Complications

  • Cardiac tamponade
  • Recurrent pericarditis
  • Constrictive pericarditis

References

  • ESC 2015 Pericardial

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