Pericarditis and Tamponade

What this deck covers

Pericarditis and Tamponade in twelve board-style clinical cases with worked explanations, written for the Saudi Prometric (SCFHS) exam, MRCPCH Part 1 and Part 2, the Arab Board, DHA and OMSB. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong.

Diagnoses and management options tested

Across the twelve cases you are asked to choose between options such as: Acute pericarditis, Musculoskeletal chest wall pain, Pneumonia with pleuritic pain, Gastro-oesophageal reflux, The heart rate and the QRS width, Prednisolone, tapered over two weeks, Ibuprofen alone, for one week, Colchicine alone, for three months, Ibuprofen with colchicine, and rest from sport, Myopericarditis, with normal ventricular function, Acute myocarditis, and he needs intensive care, Infarction from an anomalous coronary artery, Post-cardiac injury syndrome with an effusion, Ventricular failure after the procedure.

Exam pearls from this deck

• Acute pericarditis is inflammation of the double-layered sac around the heart and the great vessels.
• Stage 1 pericarditis is widespread concave ST elevation with PR depression in the same leads.
• Viral and idiopathic pericarditis account for the great majority of childhood cases.
• Ibuprofen at full anti-inflammatory dose is first line; aspirin is avoided in children for Reye syndrome.
• Myopericarditis is pericarditis with a raised troponin and preserved ventricular function.
• Post-cardiac injury syndrome is an immune pericarditis one to six weeks after the sac is injured.
• Electrical alternans is a beat-to-beat alternation in QRS amplitude with the rhythm still sinus.
• Pulsus paradoxus is an exaggerated inspiratory fall in systolic pressure; over 10 mmHg is abnormal.
• Diastolic collapse is a wall buckling inward when the pressure outside exceeds the pressure within.

The deck above is free and needs no sign-in. Work through it once for recognition, then again a week later for recall — the questions are written in the format the exam actually uses.