Pericarditis

 Etiology: Most commonly viral in origin, Other causes: rheumatic fever, trauma, connective tissue disorders (SLE, RA) pericardiotomy s/p heart surgery

Risk factors/predisposing factors: cardiac surgery, autoimmune and immunosuppressed patients, renal failure, depending on cause, women more often affected than men

Inflammation of the pericardium causes: Pain Exudate Serous à pericardial effusion Cardiac tamponade: rapid accumulation of exudate compresses the heart Fibrous à friction rub; adhesions ECG changes

Inflammation of the pericardium may restrict the heart’s movement due to: Serous exudate filling the pericardial cavity (pericardial effusion) Fibrous scar tissue making the pericardium stick to the heart (constrictive pericarditis)

On inhaling, the right ventricle fills with extra blood Because the heart cannot expand fully when the right ventricle is overfilled, the left ventricle is compressed and cannot accept much blood On the next heartbeat, the left ventricle does not send out much blood: systolic BP drops

Diagnostics: 12 lead EKG changes, CXR, ECHO Physical assessment: friction rub heard with stethoscope—a s

Treatment (depends on cause) If infectious, antibiotics for bacteria NSAIDS and ASA for inflammation and discomfort If effusion present, fluid removed by needle aspiration or surgery