Acute pericarditis

Pericarditis is one of the differentials of any patient presenting with chest pain.

Features

• chest pain: may be pleuritic. Is often relieved by sitting forwards
• other symptoms include non-productive cough, dyspnoea and flu-like symptoms
• pericardial rub
• tachypnoea
• tachycardia

Causes

• viral infections (Coxsackie)
• tuberculosis
• uraemia (causes 'fibrinous' pericarditis)
• trauma
• post-myocardial infarction, Dressler's syndrome
• connective tissue disease
• hypothyroidism

ECG changes

• widespread 'saddle-shaped' ST elevation
• PR depression: most specific ECG marker for pericarditis

© Image used on license from Dr Smith, University of Minnesota