GIM Question 20 Instructor

What are causes of pericarditis?
The causes of pericarditis include:

  • Infection – viral (most common infectious), bacterial, tuberculosis
  • Transmural myocardial infarction
  • Aortic dissection
  • Trauma
  • Neoplasm
  • Chest wall radiation
  • Uremia
  • Autoimmune or inflammatory disease
  • Drugs (adverse reaction)
  • Idiopathic (most common)

What changes might you see on ECG in a patient with pericarditis?
ECG changes from pericarditis include:

  • Diffuse ST segment elevations (concave appearance)
  • Diffuse PR segment depression
  • Widespread T wave inversion may occur later, but once the ST and PR segments return to baseline

What physical exam findings are classically associated with cardiac tamponade?
Classic physical exam findings in cardiac tamponade are: tachycardia, elevated JVP, pulses paradoxus, pericardial rub, diminished heart sounds (sometimes), hypotension (sometimes)

Resources

  1. Lange RA and Hillis LD. Acute Pericarditis. N Enlg J Med. 2005, 351:2195-2202.
  2. Maisch B et al. Guidelines on the diagnosis and management of pericardial disease executive summary; The Task force on the diagnosis and management of pericardial disease of the European society of cardiology. Eur Heart J. 2004, 25:587-610.
  3. Spodick DH. Acute Cardiac Tamponade. N Engl J Med. 2003, 349:684-690.

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