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Acute Pericarditis Interventions (OLD VERSION)

Acute-angle Pear-heart-on-fire
Picmonic
Acute pericarditis is a condition caused by inflammation of the pericardial sac related to various causes (refer to the Picmonic on "Acute Pericarditis Causes"). Although some patients may be asymptomatic, typical assessment findings include sharp chest pain, pericardial friction rub, and fever (refer to the Picmonic on "Acute Pericardial Assessment"). Interventions include treating the underlying disorder with medications including antibiotics, NSAIDs, and corticosteroids. Place the patient in an upright position and adjust the head of the bed at 45 degrees. Hospital procedures to help alleviate acute pericarditis include pericardiocentesis and creating a pericardial window to prevent the complication of cardiac tamponade.
7 KEY FACTS
INTERVENTIONS
Treat Underlying Disorder
Treating Underlying Causes

The goal of acute pericarditis therapy is to identify and treat the underlying disorder. Medication regimen may include antibiotics, NSAIDs, and corticosteroids. Assessing the patient's pain and ECG readings will help differentiate pericarditis from myocardial ischemia.

Antibiotics
ABX-guy

Antibiotics are used to treat bacterial pericarditis.

NSAIDs
N-sad

The administration of NSAIDs may help control the pain and inflammation related to acute pericarditis (refer to the Picmonic on "Ibuprofen (NSAIDs)"). Since NSAIDs may cause gastrointestinal irritation, administer these drugs with food or milk.

Corticosteroids
Quarter-on-steroids

Since corticosteroids have various side effects, they are used selectively in patients with acute pericarditis. Corticosteroids are typically prescribed for patients with underlying rheumatologic or other autoimmune conditions already taking the medication. Corticosteroids may also be administered to relieve inflammation in patients who do not respond to NSAIDs.

Place Patient Upright with Head of Bed at 45
Head of Bed at 45°

Placing the patient in an upright position with the head of the bed elevated at 45 degrees may help provide pain relief. Bed rest may also help relieve pain in patients with acute pericarditis.

Pericardiocentesis
Puncturing Pear-heart-with-incense

Pericardiocentesis is performed on patients with pericardial effusion with acute cardiac tamponade or purulent pericarditis. To relieve cardiac pressure, a needle is inserted into the pericardial space to remove fluid. Complications may include dysrhythmias, further cardiac tamponade, pneumothorax, and myocardial laceration.

Pericardial Window
Pear-heart Window

The patient with acute pericarditis may develop cardiac tamponade or pericardial effusion. Excess fluid will collect in the pericardial space. A "window" is cut on the pericardium to allow drainage of excess fluid from the pericardium to the peritoneum or chest area and can be used for diagnosis.

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