Medical-surgical Nursing Demystified

CHAPTER 1 Cardiovascular System^43

onset of pericarditis. Pericarditis may be caused by any infectious agent, AMI,
malignancy, autoimmune diseases, or drug reaction.

PROGNOSIS

Outcome of acute pericarditis is often self-limited, resolving in two to six weeks.
Patients are typically treated with nonsteroidal anti-inflammatories (NSAIDs) to
decrease the inflammation of the pericardium.

HALLMARK SIGNS AND SYMPTOMS

• Acute:
  
  
  • A grating heart sound heard (pericardial friction rub) due to friction from
    inflammation between the layers surrounding the heart
  
  
  • Sudden sharp pain over the precordium (mid- to lower sternum area) radi-
    ating to the neck, shoulders, back, and arm
  
  
  • Pain decreases when the patient leans forward, sits up
  
  
  • Teeth pain, anxiety, myalgias
  
  
  • Difficulty breathing (dyspnea), rapid breathing (tachypnea)
  
  
  • Arrhythmias
  
  
  
  


• Chronic:
  
  
  • Enlarged liver (hepatomegaly), ascites because of liver congestion
  
  
  • Increased fluid retention due to ineffective pumping
  
  
  • Pericardial friction rub
  
  
  
  

INTERPRETING TEST RESULTS

• Increase WBC and sed rate (the rate at which red blood cells settle in a test
  tube. A high rate indicates inflammation), thyroid studies, renal function, Rh
  factor, ANA complement.


• May see increased CK (creatine kinase), LDH (lactate dehydrogenase), liver
  enzymes levels.


• EKG.
  
  
  • Sinus tachycardia.