Pericarditis is an inflammation of the pericardium that can be caused by infection, connective tissue disorders, medications, or other cardiac issues. It leads to chest pain and may accumulate fluid in the pericardial sac, causing cardiac tamponade. Diagnosis involves echocardiogram, CT scan, or MRI. Treatment focuses on determining the cause, relieving symptoms like pain with NSAIDs or corticosteroids, and detecting signs of tamponade. Nursing care manages pain and encourages activity as the condition improves.

1. ACUTE
PERICARDITIS
Mrs.Susan.k
Assistant professor
Dept. of Medical-Surgical nursing
SUM Nursing College
Siksha O Anusandhan
(Deemed to be University)
Bhubaneswar

2. Pericarditis refers to an inflammation of
the pericardium, the membranous sac
enveloping the heart.
pericarditis also may occur 10 days to 2
months after acute myocardial infraction
(Dressler syndrome).
Pericarditis may be subacute, acute, or
chronic.
Definition

3. Etiology
• Infection: usually viral (eg, human
immunodeficiency virus, coxsackievirus,
influenza); rarely bacterial (eg,streptococci,
staphylococci, meningococci, gonococci,): and
mycotic (fungal).
• Disorders of connective tissue: systemic lupus
erythematosus, rhrumatic fever, rheumatoid
arthritis, polyarteritis, scleroderma.
• Hypersensitivity states: immune reaction,
medication reaction, serum sickness.

4. • Disorders of adjacent structures: myocardial
infraction, dissecting aneurysm, pleural and
pulmonary disease (pneumonia).
• Neoplastic disease: caused by metastasis from
lung cancer or breast cancer, leukemia, and
primary neoplasms.
• Radiation therapy of chest
• Trauma: chest injury, cardiac surgery,cardiac
catheterization, implantation of pacemaker or
implantable cardioverter defibrillator (ICD)
• Renal failure, uremia and tuberculosis

5. Pericaditis may lead to an accumulation of
fluid in the pericardial sac
Increased pressure on the heart, leading to
cardiac tamponade
Frequent or prolong episodes of pericarditis
may also lead to thickening and decreased
elasticity of the pericardium, or scarring may
fuse the visceral and parietal pericardium .

6. These conditions restrict the heart’s ability to
fill with blood.
The pericardium may become calcified, further
restricting ventricular expansion during
ventricular filling(diastole).
Restricted diastolic filling may result in increased
systemic venous pressure, causing peripheral
edema and hepatic failure

7. Clinical Manifestations:
Pericarditis may
be
asymptomatic
Chest pain
Mild fever
Increased WBC
count
Anemia
Elevated ESR
Nonproductive
cough Dyspnea
Heart failure-
result of
pericardial
compression

8. Chest pain
Beneath the
clavicle
In the neck
In the left
trapezius
(scapula )region

9. Assessment and diagnostic findings:
• History collection
• Echocardiogram –inflammation, pericardial effusion or
tamponade
• Pericardiocentesis-catheter drainage of the
pericardium
• Ct scan-diagnostic tool for determining the size, shape,
and location of pericardial effusion
• MRI-assist with detection of inflammation and
Adhension
• Video-assisted pericardioscope –guidedbiopsy of the
pericardium is performed to obtain tissue samples for
culture and micro scopic examination.

10. Medical management:
The objectives of Management of pericarditis are to
• Determine the cause,
• Administer therapy for treatment and symptom relief, and
• Detect signs and symptoms of cardiac tamponade.
• When cardiac output is impaired, the patient is placed on
bed rest until the fever, chestpain, and friction rub have
subsided.
Analgesics and NSAIDs such as aspirin or ibuprofen
may be prescribed for pain relief during the acute phase.
• Indomethacin is contraindicated, because it may decrease
coronary blood flow.
• Corticosteroids (eg , prednisone) may be prescribed
• colchicine may also be used as alternative therapy

11. Pericardiocentesis , a
procedure in which some of
the pericardial fluid is
remove, is rarely necessary. It
may be performed to assist in
the identification of the cause
or relieve symptoms,
especially if there are signs
and symptoms of heart
failure or tamponade.

12. Pericardial fluid is cultured
in bacterial, tubercular, or
fungal disease is
suspected.

13. A pericardial window , a small opening
made in the pericardium, may be performed to
allow continuous drainage into the chest cavity.
Surgical removal of the tough encasing
pericardium(percardiectomy ) may be necessary
to release both ventricles from the constrictive
and restrictive inflammation and scarring

14. Nursing management:
1. Patient with acute pericarditis require pain
management with analgesics, positioning, and
psychological support
2. As the patient’s condition improves, the nurse
encourages gradual increases of activity.
3. The nurse educates the patient and family about
a healthy lifestyle to enchance the patient’s
immune system
4. The primary symptom of the patient with
pericarditis is pain

15. The nurse tries to identify whether the pain is
influenced by respiratory movements, while
holding an inhaled and exhaled breath; by
extension, flexion, or rotation of the spine. By
coughing;or by swallowing.
A pericardial friction rub occurs when the
pericardial surface lose their lubricating fluid
because of inflammation.
The rub is audible on auscultation and is
synchronous with the heart beat.
If there is difficulty in distinguishing a pericardial
friction rub from a plerual friction rub, the
patient is asked to hold his or her breath: a
pericardial friction rub will continue.

16. Nursing diagnosis:
Acute pain related to inflammation of the
pericardium as evidenced by forward leaning
posture and decreased activity daily living.