Podcast 875: A Pediatric Case of Myopericarditis
Emergency Medical Minute30 Loka 2023

Podcast 875: A Pediatric Case of Myopericarditis

Contributor: Meghan Hurley MD

Educational Pearls:

  • Pericarditis is inflammation of the pericardial sac, which can arise from infectious or non-infectious etiologies

  • Myocarditis is inflammation of the myocardium, which may accompany pericarditis

  • Pericarditis clinical findings include:

    • Diffuse concave ST elevation, classic for acute pericarditis with myocardial involvement. More common in younger male patients

    • Elevated high-sensitivity troponin - higher levels may occur in young healthy patients

    • Ultrasound may show pericardial effusions

  • POCUS may be helpful in assessing left ventricular ejection fraction (LVEF) via E-point septal separation (EPSS)

    • Elevation in EPSS correlates with decreased LVEF

  • Treatments:

    • Anti-inflammatories including NSAIDs and colchicine

    • Monitor inflammation

    • Repeat ultrasounds

  • Risk factors in this patient's case:

    • mRNA COVID vaccine - the risk of myocarditis from vaccination is significantly lower than that from COVID-19 infection

    • Preceding infection

References

1. Gao J, Feng L, Li Y, et al. A Systematic Review and Meta-analysis of the Association Between SARS-CoV-2 Vaccination and Myocarditis or Pericarditis. Am J Prev Med. 2023;64(2):275-284.

2. Imazio M, Gaita F, LeWinter M. Evaluation and treatment of pericarditis: A systematic review. JAMA - J Am Med Assoc. 2015;314(14):1498-1506. doi:10.1001/jama.2015.12763

3. Mckaigney CJ, Krantz MJ, La Rocque CL, Hurst ND, Buchanan MS, Kendall JL. E-point septal separation: A bedside tool for emergency physician assessment of left ventricular ejection fraction. Am J Emerg Med. 2014;32(6):493-497. doi:10.1016/j.ajem.2014.01.045

Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit, OMSII

Jaksot(1144)

Episode 934: Subendocardial Ischemia

Episode 934: Subendocardial Ischemia

Contributor: Travis Barlock MD Educational Pearls: What is the ST segment? The ST segment on an ECG represents the interval between the end of ventricular depolarization (QRS) and the beginning of v...

9 Joulu 20243min

Episode 933: Benign Convulsions with Gastroenteritis

Episode 933: Benign Convulsions with Gastroenteritis

Contributor: Alec Coston MD Educational Pearls: Causes of seizures in a fairly well-appearing child with diarrhea: Electrolyte abnormalities: hypocalcemia, hyponatremia Also hyperkalemia which...

2 Joulu 20243min

Episode 932: Induction Agent Hypotension

Episode 932: Induction Agent Hypotension

Contributor: Aaron Lessen MD Educational Pearls: Induction agent selection during rapid sequence intubation involves accounting for hemodynamic stability in the post-intubation setting Many emerge...

25 Marras 20242min

Episode 931: Naloxone in Cardiac Arrest

Episode 931: Naloxone in Cardiac Arrest

Contributor: Aaron Lessen MD Educational Pearls: Can opioids cause cardiac arrest? Opioids can cause respiratory suppression and the subsequent low oxygen levels can lead to arrhythmias and eventual...

18 Marras 20243min

Episode 930: Holding Costs

Episode 930: Holding Costs

Contributor: Aaron Lessen MD Educational Pearls: A study evaluated the patient-care impact and financial costs of holding patients in the ED, a nationwide issue Prospective, observational study o...

15 Marras 20242min

Episode 929: Traumatic Aortic Injury

Episode 929: Traumatic Aortic Injury

Contributor: Aaron Lessen MD Educational Pearls: Aortic injury occurs in 1.5-2% of patients who sustain blunt thoracic trauma Majority are caused by automobile collisions or motorcycle accidents ...

4 Marras 20245min

Laboring Under Pressure Episode 4: Obstetric Emergency in South Africa with Dr. Meghan Hurley

Laboring Under Pressure Episode 4: Obstetric Emergency in South Africa with Dr. Meghan Hurley

Laboring Under Pressure Episode 4: Obstetric Emergency in South Africa with Dr. Meghan Hurley Contributors: Meghan Hurley MD, Travis Barlock MD, Jeffrey Olson MS3 Show Pearls Map of South Africa Refer...

31 Loka 202427min

Episode 928: Neutropenic Fever

Episode 928: Neutropenic Fever

Contributor: Taylor Lynch, MD Educational Pearls: What is neutropenic fever? Specific type of fever that is seen in cancer patients and other patients with impaired immune systems These patients a...

28 Loka 20245min

Suosittua kategoriassa Tiede

rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
tiedekulma-podcast
rss-lihavuudesta-podcast
docemilia
utelias-mieli
mielipaivakirja
radio-antro
sotataidon-ytimessa
filocast-filosofian-perusteet
rss-laakaripodi
rss-mental-race
rss-opeklubi
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-sosiopodi