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Stuart Swadron, MD, FRCPC and Mel Herbert, MD MBBS FAAEM

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Crunch Time - Heart - Written Summary 326 KB - PDF


Stuart Swadron MD and Mel Herbert MD

  • Inflammation of outside of heart
  • Usually viral but can also be secondary to
    • Uremia
    • Lupus
    • Malignancy
    • Fungal
  • Classic symptom is chest pain that improves when sitting up and leaning forward
  • ECG changes
    • Diffuse ST elevations except aVR and V1
    • Changes are split into stages (can take weeks to months to years to progress through stages)
      • PR depression and ST segment elevation
      • ECG normalizes
      • T wave inversion phase
      • ECG normalizes
  • May hear “rub” on auscultation
  • Check troponin to rule out myocarditis
  • Imaging
    • Ultrasound to look for effusion and tamponade
  • Treatment
    • Usually discharge home if stable
    • NSAIDs
    • Colchicine can prevent sequelae

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Heart Full episode audio for MD edition 127:08 min - 177 MB - M4ACrunch Time - Heart - Individual MP3 Files 164 MB - ZIPCrunch Time - Heart - Written Summary 326 KB - PDF

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