Pericardial diseases
Big picture
Pericardial diseases are disorders of the pericardial sac around the heart. In the exam, you must separate four major clinical patterns:
| Pattern | Core idea |
|---|---|
| Acute pericarditis | Inflamed pericardium → sharp pleuritic chest pain + friction rub + diffuse ST elevation |
| Pericardial effusion | Fluid accumulates in pericardial sac |
| Cardiac tamponade | Pericardial pressure compresses the heart → obstructive shock |
| Constrictive pericarditis | Thick, rigid pericardium blocks diastolic filling → right-sided heart failure |
The most dangerous diagnosis is cardiac tamponade: hypotension, raised jugular venous pressure, muffled heart sounds, tachycardia, pulsus paradoxus → urgent echo-guided pericardiocentesis.
Modern ESC guidance includes pericarditis under inflammatory myocardial and pericardial syndromes, emphasizing symptom-driven assessment, echocardiography, cardiac magnetic resonance imaging when needed, risk stratification, and anti-inflammatory therapy. ([European Society of Cardiology][1])
Unlock the rest of this topic
Subscribe to Internal Medicine for $10/month and unlock all 229 topics — full exam-structured notes, the State Exam questions integrated into every topic, and the downloadable Anki deck. Cancel anytime.
- ✓All 229 Internal Medicine topics, exam-structured
- ✓State Exam questions in every topic
- ✓Downloadable Anki deck (.apkg)
- ✓Cancel anytime
Already subscribed? Sign in