Paricarditis.pptx
- 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