A few days ago we talked about a fascinating case involving a person presenting with chest pain and found to have both pericarditis and a lobar pneumonia. To unify the diagnosis we looked at the differential for pericarditis that includes but is not limited to:
· Infectious Causes: viral (coxsakie virus A, B, echovirus…); bacterial (s. pneumonia, s. aureua…); TB; fungal (histoplasmosis, blastomycosis..)
· MI associated: acute vs Dressler’s syndrome
· Metabolic: uremia, hypothyroidism
· Neoplasm: lymphoma, breast, lung, RCC, melanoma
· CVD: SLE, RA, scleroderma, polyarteritis
· Vascular: aneurysm, trauma, cardiac surgery
· Other: drugs (hydralazine), radiation, sarcoid
We also had the chance to look at an ECG which showed some (but not all) of the changes we associate with pericarditis including diffuse ST elevation, PR segment depression (elevation in aVR), concave morphology to ST segment elevation.
For more information on pericarditis look at this NEJM review:
http://content.nejm.org/cgi/reprint/351/21/2195.pdf
Finally, the team discussed some clinical trial evidence for the treatment of pericarditis. The colchicine in addition to conventional therapy for acute pericarditis (COPE TRIAL) can be found at the link below!
http://www.circ.ahajournals.org/cgi/content/full/112/13/2012
1 comment :
aaawwwww cute. i like the hearts.
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