2. INTRODUCTION
• Pericarditis is swelling and irritation of the thin, saclike
tissue surrounding the heart (pericardium).
• Pericarditis often causes sharp chest pain. The chest pain
occurs when the irritated layers of the pericardium rub
against each other.
• Pericarditis is usually mild and goes away without
treatment.
3. DEFINITION
• Pericarditis is an inflammation of the pericardium, which
is
a thin, two-layered, fluid-filled sac that covers the outer
surface of heart.
• Sometimes there is extra fluid in the space between the
pericardial layers, which is called pericardial effusion.
4.
5. TYPES
• Acute pericarditis: Inflammation of the pericardium that
develops suddenly along with the sudden onset of symptoms.
• Chronic pericarditis: Inflammation of the pericardium that
lasts for three months or longer after the initial acute attack.
• Constrictive pericarditis: A severe form of pericarditis in
which the inflamed layers of the pericardium stiffen, develop
scar tissue, thicken and stick together. Constrictive
interferes with heart’s normal function. This usually happens
after multiple episodes of acute pericarditis over time.
6. TYPES (CONTD.)
• Infectious pericarditis: develops as the result of a viral, bacterial,
fungal or parasitic infection.
• Idiopathic pericarditis: Pericarditis that doesn’t have a known cause.
• Traumatic pericarditis: develops as the result of an injury to the
chest, such as after a car accident.
• Uremic pericarditis: develops as the result of kidney failure.
• Malignant pericarditis: develops as result of a cancer growing in the
body.
7. CAUSES
• A complication of a viral infection, most often a
gastrointestinal virus, causes viral pericarditis.
• A bacterial infection, including tuberculosis, causes
bacterial pericarditis.
• A fungal infection causes fungal pericarditis.
• An infection from a parasite causes parasitic
pericarditis.
• Some autoimmune diseases, such as
lupus, rheumatoid arthritis and scleroderma, can
cause pericarditis.
8. CAUSES (CONTD.)
• Injury to the chest, such as after a car accident, causes traumatic
pericarditis.
• Kidney failure causes uremic pericarditis.
• Tumor like lymphoma causes malignant pericarditis.
• Genetic diseases such as Familial Mediterranean Fever (FMF).
• Medications that suppress the immune system (This is rare).
9. RISK FACTORS
• A heart attack.
• Open heart surgery (post-pericardiotomy syndrome).
• Radiation therapy.
• Percutaneous treatment, such as cardiac
catheterization or radio frequency ablation (RFA).
10. SIGN & SYMPTOMS
• Sharp and stabbing chest pain (This happens when the heart
rubs against pericardium).
• It get worse when patient cough, swallow, take deep breaths
or lie flat.
• Feels better when one sits up and leans forward.
• Patient might feel the need to bend over or hold their chest
breathe more comfortably.
11. SIGN & SYMPTOMS (CONTD.)
• Pain in back, neck or left shoulder.
• Trouble breathing when patient lies down.
• A dry cough.
• Palpitations (feeling like the heart is racing or beating
irregularly).
• Anxiety or fatigue.
• Fever.
• Swelling of legs, feet and ankles in severe cases.
12. DIAGNOSIS
CHEST X-RAY
• To see for the size of heart
• Any fluid in lungs ?
ELECTROCARDIOGRAM
• To look for changes in the
heart rhythm
ECHOCARDIOGRAM
• To see for the heart functioning /
working
• Check for fluid (a pericardial
effusion) around the heart.
CARDIAC MRI
• To check for extra fluid in
pericardium, pericardial
inflammation or thickening, or
compression of heart
13. DIAGNOSIS (CONTD.)
CT SCAN ( IODINE DYE)
• To look for calcium in the
pericardium, fluid, inflammation,
tumors and disease of the areas
around the heart and more
information about inflammation.
CARDIAC CATHETERIZATION
To get information about the
filling pressures in the heart.
BLOOD TESTS
• Sedimentation rate (ESR)
• Ultra-sensitive C reactive protein
levels (markers of inflammation)
OTHERS
Check for autoimmune diseases
like lupus and rheumatoid
arthritis.
14. MEDICAL MANAGEMENT
• Antibiotic / antifungal medications.
• Anti-inflammatory drug called colchicine.
• Medications to ease gastrointestinal (stomach and
digestive) symptoms, if large doses of nonsteroidal
anti-inflammatory drugs (NSAIDS) have been taken.
• A diuretic (“water pill”) usually helps get rid of the
extra fluid in constrictive pericarditis causes.
15. SURGICAL MANAGEMENT
• PERICARDIOCENTESIS - A minimally invasive surgical procedure is
done by using a long, thin tube (catheter) inserted through a
pericardial window and is used to drain the extra fluid. Or either by
making an opening in the pericardium through a small chest incision
to drain fluid from pericardium.
PERICARDIAL
EFFUSION
(fluid builds up
in the space
between the
pericardium)
CARDIAC
TAMPONADE
(a severe
compression of
the heart that
impairs its
ability to
function)
16. SURGICAL MANAGEMENT (CONTD.)
• PERICARDIECTOMY some of the pericardium might need to be
removed in patients who develop scar tissue in their
pericardium. It’s not recommended for patients who have
active inflammation and chest pain from pericarditis.
17. NURING MANAGEMENT
oMonitor patient pain level and evaluate pain within 30 minutes.
oAdminister prescribed pain medication such as morphine to relieve pain.
oMonitor the patient pain level and effectiveness of analgesics.
oProvide a comfortable position (sit up and lean forward).
oCheck vital signs and record them continuously.
oDiscuss disease process and signs and symptoms expanding aneurysm or impending
aneurysm.
18. NURSING MANAGEMENT (CONTD.)
oIf surgical intervention is needed, provide psychological support, and prepare for surgery.
oFor post-surgical patients, discuss warning signs of postoperative complications such as
fever, inflammation in the surgical site, bleeding, and swelling.
oDaily check of weight.
oClosely monitor and notify a physician about persistent cough, vomiting, or systolic blood
pressure above 180mmhg because of the increased risk for hemorrhage.
19. NURSING MANAGEMENT (CONTD.)
oEnsure bed rest until fever, chest pain and friction rub disappear.
oAdminister O2 and keep SPO2 ˃90%.
oAdminister medication as order-such as NSAIDs and steroids with food.
oEnsure administer of antibiotic timely.
oContinue I.V antihypertensive medication if persistent blood pressure high.
oCarefully maintain fluid intake and output.
20. NURSING MANAGEMENT (CONTD.)
oReassure the patient that chest pain is not a Myocardial Infarction.
oCheck signs and symptoms for cardiac tamponade at least 8 hourly and PRN.
oAssist the patient with bathing if necessary.
oProvide a bedside commode to reduce stress on the heart.
oTell the patient to resume his daily activities slowly.
oBuild a rapport relationship with the patient to reduce anxiety.
