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Inflammation of the pericardial sac from infection, MI (Dressler’s Syndrome), renal failure (uremia), etc.
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.
DX: Chest x-ray and echocardiogram.
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).
TX: Anti-inflammatory agents (ibuprofen, aspirin, indocin, etc.), not NTG; allow to lean forward.
Monitor for cardiac tamponade, pleural effusion, constrictive pericarditis.
Dennison, Robin. Pass CCRN 4th ed., 2013.
Hazinski, M. (2015). 2015 handbook of emergency cardiovascular care for healthcare providers. Dallas, TX: American Heart Association.
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.
Juarez, P. (2015). Barron's CCRN Exam.
Vonfrolio, Laura G., Critical Care Examination Review, 4th ed., 2015.