Cardiology
Pericarditis & Tamponade
Cardiology

Pericarditis & Tamponade

Acute pericarditis (NSAID + colchicine), constrictive, tamponade.

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◆Acute pericarditis

  • •Pleuritic chest pain better leaning forward + friction rub + diffuse ST↑ + PR↓
  • •Most common: viral (Coxsackie)
  • •Treat: NSAIDs + colchicine
  • •Post-MI (early): ASA (avoid non-aspirin NSAIDs early; impair myocardial healing)
  • •Uremic: hemodialysis (not NSAIDs)
  • •Purulent: antibiotics + drainage

◆Constrictive pericarditis

  • •Rigid pericardium → impaired diastolic filling
  • •TB endemic regions: TB most common; US: viral or post-radiation
  • •Pericardial knock + elevated JVP + Kussmaul sign (paradoxical ↑JVP with inspiration)
  • •CXR/CT: pericardial calcifications
  • •Pericardiectomy if severe

◆Cardiac tamponade

  • •Beck's triad: hypotension + JVD + muffled heart sounds
  • •Pulsus paradoxus >10 mm Hg with inspiration
  • •Clear lungs distinguishes from cardiogenic shock
  • •Echo: RV diastolic collapse, IVC plethora
  • •Pericardiocentesis (echo-guided)
  • •Common causes: malignancy, viral, uremia, dissection
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