Pericarditis is inflammation of the pericardium, causing sharp chest pain and potentially leading to complications like pericardial effusion and cardiac tamponade. The condition can be infectious or noninfectious, with various causes including viruses, bacteria, trauma, and autoimmune diseases. Diagnosis includes a physical examination, ECG, and imaging tests, with treatment options ranging from NSAIDs and antibiotics to pericardiocentesis in severe cases.

1. Pericarditis
Nsg.Instructor
Safoora Qureshi
CON, PIMS

2. Pericardium:
• Pericardium is the outer most
layer and is made up of two
fibrous serous sacs
Functions:
• Limits cardiac distention
• Restricts excessive movements
• Protect from injury
• Lubricate to prevent friction
• Hold the heart in place

3. Pericarditis
• Pericarditis is inflammation of the pericardium,
• 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.

5. Etiology
Infectious Pericarditis
• Viral : coxsackievirus, adenovirus, mumps, varicella zoster, HIV,
Covid-19
• Bacterial: pneumococci, streptococci, staphylococci , tuberculosis,
Septicemia from gram- negative organisms
• Fungal . Candida
• Torch Infections: Toxoplasmosis
Noninfectious:
• Acute MI
• Neoplasms: ca lung, ca breast, leukemia, lymphomas
• Trauma: Thoracic surgery, pacemaker incretion, diagnostic
procedures
• Radiation, Dissecting aortic aneurysm
Autoimmune:
• Lupus, rheumatoid arthritis and scleroderma

6. Symptoms
Chest pain, is the most common symptom,
• Characterized by Sharp or stabbing pain,
may dull, achy or pressure-like chest pain
• Locate behind the breastbone,
or on the left side of the chest.
• Radiate to the left shoulder and neck
• Get better when sitting up or leaning forward
• Referred to trapezius muscles (shoulder, upper back)
is only the distinction between pericardial pain and angina

7. Other signs and symptoms
• Fever
• Shortness of breath
• when lying down
• Pericardial friction rub,
• is a scratching, grating, and high-pitched sound one of the
hallmark finding in acute pericarditis
• Cough
• Fatigue
• Palpitation
• Pounding or racing heartbeat)

8. Types
• Acute pericarditis:
• Begins suddenly but doesn't last longer than three weeks
• Difficult to differentiate between acute pericarditis and MI pain
• Recurrent pericarditis:
• Occurs about four to six weeks after an episode of acute pericarditis
with no symptoms in between.
• Incessant pericarditis:
• Lasts about four to six weeks but less than three months.
• The symptoms are continuous.
• Chronic constrictive pericarditis;
• usually develops slowly and lasts longer than three months.

9. Complications
• Pericardial effusion
• The fluid buildup can lead to further heart complications.
• Constrictive pericarditis).
• long-term pericarditis develop permanent thickening and scarring of the
heart lining
• The changes prevent the heart from filling and emptying properly.
• Cardiac tamponade)
• Pressure on the heart due to fluid buildup
• Prevents the heart from filling properly.
• Causing a dramatic drop in blood pressure.
• A life-threatening condition requires emergency treatment

10. Diagnosis
• History and Physical Examination
• Sharp chest pain and shortness of breathing are 2 major clues
• Heart Auscultation:
• Rubbing or creaking sound, called “pericardial rub” is the best
heard when the pt lean forward, hold breath and breathe out.
• Crackles in the lungs, which are signs of pleurisy or pericardial
effusion
• ECG: Normal/specific defused changes over aperid of hours to
days/wks. we
• PR segment depression,
• ST segment elevation and
• T wave flattening

11. Pericarditis
PR segment depression
ST segment elevation
T flattening
Normal ECG

12. • Chest X-ray
• to see the size of the heart and any fluid in lungs.
• Echocardiogram (echo) ;
• To find fluid or pericardial effusion around the heart
• Cardiac MRI;
• CT scan;
• to look for calcium in the pericardium, fluid, inflammation, tumors
around the heart
• Cardiac catheterization:
• to confirm a diagnosis of constrictive pericarditis.
• Blood tests
• ESR, CRP,
• To confirm heart attack
• To find the cause of pericarditis.
•

13. Collaborative Care
Medical treatment:
• Pain Relievers:
• Nonsteroidal anti-inflammatory (NSAIDs) use to treat pain and inflammation
such as aspirin or Ibuprofen
• Antibiotics :
• to reduce inflammation and pain
• Steroids:
• strong anti-inflammatory drug, may used in pericarditis secondary to
autoimmune conditions
• Pericardiocentesis:
• is usually performed for pericardial effusion with cardiac tamponade,
purulent pericarditis and a high suspicious of neoplasm

14. Nursing management:
• Strict bed rest
• Keep in prop-upped position
• Elevate the bed at 45 degree
• Provide an overbed table for support
• Observe for post anti-inflammatory drugs complications such as upper GI
bleed, gastric upset etc
• Advise to take these drugs with food and milk
• Instruct avoid alcohol beverages
• Take anxiety-reduce measures by explaining performed procedures and
possible cause of pain , treatment and prognosis
• Reassure the client