Acute Medicine | Cardiovascular | Pericarditis: Investigation and management

Pericarditis: Investigation and Management
Session Overview
Description
This session considers causes of acute pericarditis, appropriate investigations to perform and management options.

Learning Objectives
By the end of this session you will be able to:

• Recognise characteristic signs and symptoms of acute pericarditis
• State which investigations can be performed for acute pericarditis
• Recognise indications for pericardiocentesis and pericardial biopsy
• Determine which patients with acute pericarditis can be discharged
• Identify management strategies for acute pericarditis

The pericardium

The pericardium is a fibroelastic sac made up of visceral and parietal layers separated by a (potential) space, the pericardial cavity (Fig 1).

In healthy individuals, the pericardial cavity contains 15-50 mL of an ultrafiltrate of plasma.

Diseases of the pericardium can be classified as:

• An isolated problem of the pericardium, or
• A result of systemic illness

Pericardial response to disease is inflammation and production of pericardial fluid. Depending on the chronicity, severity and duration of this inflammation, the patient may present with one of four clinical manifestations:

• Acute and recurrent pericarditis
• Pericardial fluid without major haemodynamic compromise
• Cardiac tamponade
• Constrictive pericarditis