Peri/Myocarditis Lecture Notes

Comprehensive vocabulary flashcards covering the etiology, clinical findings, ECG differentiation, and management of pericarditis, myocarditis, and related syndromes.

Acute Pericarditis Diagnostic Criteria

Diagnosis requires at least two of the following: typical chest pain, pericardial friction rub, suggestive ECG changes (typically widespread ST segment elevation), and new or worsening pericardial effusion.

Fibrous Pericardium

The outermost layer of the pericardium.

Epicardium

The visceral layer of the serous pericardium.

Pericardial Cavity

The space located between the visceral pericardium and the parietal pericardium.

Pericardial Friction Rub

A characteristic clinical finding identified during a bedside examination of a patient with pericarditis.

Cardiac Markers

Diagnostic studies used to indicate myocardial involvement (epimyocarditis).

Uremic Pericarditis Diagnostic Hint

Suggestive BUN/creatinine levels in patients with renal failure.

ST-segment Elevation Morphology (Pericarditis)

Begins at the J point, rarely exceeds $5\,mm$ in height, and maintains a normal concavity.

ST-segment Elevation Distribution (MI)

Found in anatomical groupings of leads that correspond to a specific vascular territory of infarction.

PR segment changes in Acute Pericarditis

Typically presents as PR elevation in lead aVR and PR depression in most or all other leads.

High-risk Markers in Acute Pericarditis

Includes fever $>38^{\circ}C$ ($100.4^{\circ}F$), subacute course, hemodynamic compromise (tamponade), large pericardial effusion, immunosuppression, use of vitamin K antagonists, acute trauma, or elevated troponin.

First-line Treatment for Acute Pericarditis

Involves management with NSAIDs, Colchicine, and restriction from strenuous activity.

Aspirin Dosage (Pericarditis)

$750-1000\,mg$ PO every $8$ hours.

Ibuprofen Dosage (Pericarditis)

$600-800\,mg$ PO every $8$ hours.

Colchicine Dosage ($\ge 70\,kg$)

$0.5$ (or $0.6$) $mg$ PO twice daily for a duration of $3$ months.

Uremic Pericarditis

A condition occurring secondary to renal failure or dialysis; it is one of the most common causes of cardiac tamponade.

Early Post-MI Pericarditis

Occurs within $4$ days after MI due to transmural necrosis causing direct pericardial inflammation; typically self-limiting.

Dressler Syndrome

Post-MI pericarditis seen $2-8$ weeks after an infarction, often treated with Ibuprofen $600\,mg$ QID or Indomethacin $25\,mg$ TID.

Myocarditis

A condition histologically defined by the presence of a mononuclear cell infiltrate in myocardial cells.

Coxsackie B Virus

A common viral infectious cause of myocarditis.

Myopericarditis (Definite)

A diagnosis of acute pericarditis plus suggestive symptoms (dyspnea, palpitations, chest pain), ECG abnormalities, and evidence of elevated cardiac enzymes or new focal/diffuse depressed LV function.

Confirmed Myopericarditis

Established by histopathologic evidence of myocarditis from an endomyocardial biopsy or autopsy.

Anakinra

An Interleukin-1 inhibitor used as alternate therapy for complicated pericarditis, dosed at $100\,mg$ subQ once daily.

Pericardiectomy

An intervention reserved for symptomatic refractory constrictive pericarditis.