Pericardial diseases

Posted by e-Medical PPT Wednesday, April 18, 2012
Identify signs and symptoms of pericardial diseases
Discuss workup and treatment strategies for pericarditis
List common causes of pericarditis and pericardial effusion

The Periicardiium
Outer fiibrous llayer
Inner lliiniing (serous)
– Visceral pericardium(epicardium)
– Parietal pericardium lines outer fibrous layer
Periicardiiall space is in between viiscerall and parietal periicardiium
– Normally 15-50mL of fluid

Case 1
32 year olld Malle
1 week ago started wiith sore throat,
Develloped chest paiin (pressure)
– Left substernal
– Radiating to neck
– Improves when sitting up
No siigniifiicant mediicall, famiilly, sociiall
No mediicatiions
Physiicall Exam unremarkablle

What is the most lliikelly diiagnosiis?
1. Acute myocardial infarction
2. Acute pericarditis
3. Acute myopericarditis
4. Constrictive pericarditis
5. Pericardial tamponade

What woulld you do nextt?
1. Cardiac Catheterization
2. Echocardiography
Or go straight to treatment without imaging:
3. High dose NSAIDS
4. High dose NSAIDS + Colchicine
5. Prednisone

What is the Most Common Cause of Acutte Pericarditis?
1. Idiopathic/Viral
2. Bacterial
3. Malignancy
4. Uremia
5. Acute Myocardial Infarction
6. Autoimmune disease

Diagnostic Criteria for Pericarditis
Two of Four criteria
–Characteristic chest pain
–Pericardial friction rub
–Suggestive EKG changes
–New or worsening pericardial effusion

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