Study Notes on Pericarditis

Overview of Pericarditis

  • Definition: Pericarditis is the inflammation of the pericardium layer of the heart.

Understanding the Pericardium

  • Definition of Pericardium:

    • A double-walled sac that surrounds the heart, consisting of two layers:

      • Fibrous Pericardium: The outer layer, providing protection and anchoring the heart to surrounding structures.

      • Serous Pericardium: The inner layer that consists of two parts:

        • Parietal Layer: Lines the inner surface of the fibrous pericardium.

        • Visceral Layer (Epicardium): Adheres directly to the heart muscle.

  • Location: Encloses the heart and creates a space known as the pericardial cavity, which contains pericardial fluid that lubricates the heart's movement.

Causes of Pericarditis

  • Infectious Causes:

    • Viral infections (e.g., Coxsackievirus, Echovirus)

    • Bacterial infections (e.g., tuberculosis, pneumococcus)

    • Fungal infections

  • Non-infectious Causes:

    • Autoimmune disorders (e.g., lupus, rheumatoid arthritis)

    • Post-myocardial infarction (Dressler's syndrome)

    • Neoplasms (e.g., cancer metastasis to the pericardium)

    • Trauma or injury to the chest

    • Uremia (kidney failure)

Types of Pericarditis

  • Acute Pericarditis: Occurs suddenly and lasts for less than 3 months.

  • Chronic Pericarditis: Persists for more than 3 months and can be recurrent.

  • Constrictive Pericarditis: Caused by thickening and scarring of the pericardium, leading to restricted heart function.

  • Effusive Pericarditis: Characterized by the accumulation of excess fluid in the pericardial cavity.

Complications of Pericarditis

  • Cardiac Tamponade: A serious condition where fluid accumulation compresses the heart, impairing its ability to pump blood.

  • Chronic Pain: Ongoing chest pain can persist after the acute episode.

  • Pericardial Effusion: Accumulation of fluid more than 15-50ml in the pericardium

  • Constrictive Pericarditis: Can develop over time and leads to heart failure.

Nursing Interventions

  • Assessment:

    • Monitor vital signs (especially heart rate and blood pressure).

    • Assess for classic signs and symptoms: chest pain (sharp and pleuritic), fever, and pericardial friction rub.

  • Pain Management:

    • Administer NSAIDs for pain relief and inflammation reduction.

  • Education:

    • Educate the patient about activity restrictions during acute episodes and signs of complications to monitor.

Pharmacological Aspects

  • NSAIDs: Commonly used to relieve pain and inflammation.

  • Colchicine: May be prescribed for recurrent pericarditis, not to eat grape food as it causes toxicity. Med can be taken in an empty stomach or with food

  • Corticosteroids: Used in cases where NSAIDs and colchicine are ineffective, particularly in autoimmune related pericarditis.

  • Antibiotics: Indicated if a bacterial infection is confirmed.

Additional Resources

  • After completing this lecture, visit registerednursera.com for a free quiz on pericarditis to test your knowledge.