Pericarditis

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Pericarditis

• Inflammation of pericardium

Causes

• Coxsachie virus
  • young adults
  • lasts few week
  • prognosis usually good
• Myocardial Infarction
• Uraemic
  • terminal stages
  • asymptomatic
• Bacterial
  • Staphylococcus aureus
  • Haemophilus Influenzae
  • usually fatal
• Tuberculous
• Malingnancy
• Rheumatoid arthritis

History

• sharp chest pain
  • substernal
  • relieved by sitting forward
  • aggravated by movement and respiration
  • may be referred to neck / shoulders

Examination

• fever
• pericardial friction rub
• Pericardial Effusion

Investigation

• ECG
  • ST segment elevation in first week
    • concave upwards
    • anterior, lateral and inferior leads
    • AVR, V₁, (V₂) show ST depression
• cardiac enzymes
  • may be raised

Treatment

• Non Steroidal Anti Inflammatory Drugs
• Corticosteroids

Complications

• Pericardial Effusion
• Constrictive Pericarditis

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