التهاب التامور

Definition

Pericarditis is inflammation of the double-layered sac around the heart, sometimes with fluid collecting between its layers.

Causes

• Viral infection (most common)
• After MI: early within days, or late after weeks (Dressler syndrome)
• Kidney failure, autoimmune disease, cancer and cardiac surgery

Symptoms

• Sharp chest pain worse on inspiration and lying flat, eased by sitting and leaning forward
• Low-grade fever
• A pericardial friction rub on auscultation

Diagnosis

• ECG: widespread concave ST elevation with PR depression
• Echocardiography to look for effusion

Treatment

• NSAIDs or aspirin with colchicine
• Treat the cause and limit exertion until symptoms settle

Nursing care

• Sitting up and leaning forward to ease the pain
• Watch for tamponade: hypotension, raised JVP, muffled sounds and pulsus paradoxus

Exam point

Pain that changes with position and breathing favours pericarditis; MI pain does not change with position.