Pericarditis - Cardiovascular - Medbullets Step 2/3

Snapshot
- A 60-year-old woman presents with chest pain. She reports the chest pain started today and describes it as sharp and brief. When she sits up, the pain improves. She has no significant past medical history but endorses a viral respiratory infection a few days ago. On physical exam, she is in no acute distress. She has a low-grade fever. An electrocardiogram shows widespread ST segment elevation and PR depression in the precordial leads.

Summary
- Pericarditis is a condition that results from inflammation of the pericardium characterized by sharp pain worsened by inhalation. It is most often idiopathic, but often due to viral illness, myocardial infarction, or radiation therapy. Patients present with pleuritic chest pain, usually relieved by sitting forward.
- Diagnosis is made when MI and pneumonia are ruled out with imaging and ECG, and PR depression is highly specific for pericarditis. X-rays can be normal in many patients, so other modalities like echocardiography and CT can help visualize inflammation and effusion in the pericardium.
- Treatment is usually pain relief, NSAIDs, and addressing the underlying cause. Operative treatment is indicated when there is an ineffective pharmacological response and in patients with chronic disease.

Anatomy
- Pericardium is the membrane that encloses the heart
  
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Diagnosis
- Acute pericarditis requires 2/4 of the following criteria to be present to diagnose
  
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Prognosis
- Overall favorable prognosis
  
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- Can recur or develop into chronic pericarditis

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