Pericarditis and Myocarditis

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“ Inflammation of the pericardium”
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Chest pain
Dry cough, fever , fatigue
Pericardial rub
ST elevation on ECG
Cardiac tamponade
CCF
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Infection -viral, bacterial
Secondary to recent cardiac surgery
Post MI
IV Drug abuse
Kidney failure
Metatastic disease
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Restricts the heart – reduces operative chamber
compliance
Thickened pericardium isolates heart from
normal respiratory swing, however respiratory
fluctuations in pulmonary venous pressure still
occurs
Tamponade
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Bacterial – antibiotics
Fungal – antifungal agents
Hospitalisation
Constictive
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Pericardetomy may be required
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ST elevation in any lead
May be in all leads
May not be anatomically grouped
J-point notching can be presentpresent
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Fish hook
• Look for notch at J-point
– ST segment and J-point create a “fish hook”
appearance
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Stage I
everything is UP (i.e., ST elevation in almost all leads - see below)
Stage II
Transition ( i.e., "pseudonormalization").
Stage III
Everything is DOWN (inverted T waves).
Stage IV
Normalization
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Inflammation of the heart muscle
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Generalised aches and pains
fever
SOB
chest pain
Increase in heart rate
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Viral – coxsackievirus B
Bacteria – Staphyloccus aureus, borrelia
burgdorferi
Diptheria
Parasites – trypanosoma cruzi
Fungi
Chemicals
Medications
Systemic diseases
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ECG – non specific changes
Echo- enlarged heart
Biopsy
NB ECG can be normal
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REST
Steroids – severe cases
May need to manage electrolyte imbalances or
complications of heart failure
NB 10% of patients proceed to develop dilated
cardiomyopathy
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