Acute Pericarditis

1. Inflammation of the pericardial sac from infection, MI (Dressler’s Syndrome), renal failure (uremia), etc.

2. S/S: Sudden onset of retrosternal chest pain exacerbated by inspiration, activity, and supine position; and relieved by leaning forward or sitting up; pericardial friction rub at left sternal border; tachycardia and tachypnea; low-grade fever.

3. DX: Chest x-ray and echocardiogram.

4. 12 lead ECG: global (diffuse, widespread), concave ST segment elevation in most or all leads without reciprocal changes; tall, peaked T waves in all leads except aVR; PR depression; downsloping TP segment (Spodick's sign).

5. TX: Anti-inflammatory agents (ibuprofen, aspirin, indocin, etc.), not NTG; allow to lean forward.

6. Monitor for cardiac tamponade, pleural effusion, constrictive pericarditis.

Resources

• Here’s the Rub: STEMI versus Pericarditis. Retrieved 12/22/19 from http://lifeinthefastlane.com/heres-the-rub-stemi-vs-pericarditis/

• Kent, K. (2014). Adult CCRN Certification Review: Think in Questions, Learn by Rationale. New York: Springer Publishing Company.

• CEN® Study Guide Paper Copy: Bartley, Pamela: 9781737427742: Books (amazon.com)

• CCRN® Study Guide 2022: Critical Care Registered Nurse: Bartley, Pamela: 9781737427780: Books (amazon.com)