Pericarditis involves inflamation of the pericardium which are the serosal membranes in which the heart proper is located. A major function of the pericardium is lubrication and allowing the major changes in heart chamber size that occur during the cardiac cycle. This can be seriously disturbed in constrictive pericarditis or pericardial tamponade.
Acute pericarditis is commonly caused by:
- Myocardial infarction adjacent to the percardium (Dressler's syndrome).
- Open heart surgery (Dressler's syndrome).
- Viral infection (especially Coxsackievirus B but just about any enterovirus, herpes virus, mumps, influenza and adenovirus or HIV)
Septic pericarditis is an important diagnosis not to miss. Dressler's syndrome is important to recognise as such with its classic onset a few days to weeks after the cardiac insult.
- Presence of a cardiac rub
- Characteristic ST changes. Typical ECG findings include diffuse concave-upward ST-segment elevation and, occasionally, PR-segment depression in the in all precordial leads. ECG changes of both acute myocardial infarction and early repolarization can appear similar to ECG changes of acute pericarditis.