PPT of PERICARDITIS

1. PERICARDITIS
Prepared by
Asso.Prof Mr.Vijayreddy Vandali
M.Sc(N),PGDHA,PGCDE
Med-Surgical Nursing dept.

2. DEFINITION
•Pericarditis is acute or chronic
inflammatory process of the visceral or
parietal pericardium.

3. NORMAL LAYER OF HEART

4. PATHOPHYSIOLOGY

5. •Due to etiological factors
•Pericardial cells are injured
•They release a combination of fluid, fibrin,
and cells in an inflammatory response
•Fever The serofibrous exudates
roughens the 2 layers &
creates friction between them

6. Contd…
•Pericardial friction rub occurs
•There is often irritation &
inflammation of the surrounding
pleura & diaphragmatic tissue
• Pain

7. CLINICAL MANIFESTATION
•Chest pain:- Progressive frequently chest pain
that is sharp & pleuritic in nature. The pain is
generally occurs with deep respiration& when
lying supine.
•It is relieved by sitting, the pain may radiate to
the neck, arms or left shoulder.
•One distinction is that the pain from
Pericarditis can be referred to the trapezius
muscle.

8. CONTd…
•It often is not relived by nitroglycerin or
morphine. Pain usually 4 to 48 hours
before a rub is heard.
•Pericardial friction rub:
•In most cases, Pericarditis is diagnosed by
the appearance of the rub, specific, heard
best at LSB, usually appearing on the 2nd
or
3rd
day after MI.

9. CONTd…..
•The sound of the rub can be scratching,
gating, crunching or squeaking .
•A three component rub reflects the
heart’s movement during atrial systole,
ventricular systole & ventricular diastole.

10. Contd….
Fever
• Dyspnea and tachypnea:- These
respiratory changes can be secondary to
anxiety or respiratory splitting to avoid
the pain of deep breathing . Pulmonary
tissue compression can cause dyspnea.
• Restless, irritability & anxiety:- Occur
due to stimulation of Sympathetic Nerve.

11. EKG
Electrocardiogram in acute pericarditis showing diffuse upsloping ST segment elevations seen best here in
leads II, III, aVF, and V2 to V6. There is also subtle PR segment deviation (positive in aVR, negative
in most other leads). ST segment elevation is due to a ventricular current of injury associated with
epicardial
inflammation; similarly, the PR segment changes are due to an atrial current of injury which, in Pericarditis,
typically displaces the PR segment upward in lead aVR and downward in most other leads.

12. Pericardial Effusion
Cardiomegaly due to a massive pericardial effusion. At least 200 mL of pericardial
fluid must accumulate before the cardiac silhouette enlarges.

13. CompliCations
•Arrhythmias :- it may be due to
irritation of the sinus node, which is
located close to the parietal
pericardium. Atrial arrhythmias,
especially Atrial flutter &
ateroventricular conduction
disturbance.

14. Contd….
•Pericardial Effusion:- accumulation of
fluid with in the pericardial sac is
called “Pericardial Effusion”. The fluid
may be serious, purulent or
hemorrhagic.

15. Pericardial Effusion

16. Contd…
•Cardiac Tamponade:- it develop as
the pericardial effusion increases in
size compensatory mechanism
ultimately fail to decreased cardiac
output. This can lead to cardiac
failure, shock & death.

17. Cardiac Tamponade

18. treatment
•NSAIDs
•Aspirin (2-5 g/day)
•Ibuprofen (300-800 mg q6-8H)
•Narcotics
SAID of choice unless associated with acute MI, where all non-ASA NSAIDs should be avoid

19. thank you