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

Related in WardRound

Educational — verify locally.

WardRound

WardRound

Clinical Decisions in Seconds