Podcast 875: A Pediatric Case of Myopericarditis

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

Avsnitt(1145)

Podcast #310: Bicarb in DKA

Podcast #310: Bicarb in DKA

Author: Gretchen Hinson, M.D. Educational Pearls: Controversial topic. Pathophysiology - acidosis leads to an extracellular potassium shift. Patients in DKA will be intracellularly potassium deplete,...

26 Mars 20185min

Podcast #309: Return Visits to the ED for UTI

Podcast #309: Return Visits to the ED for UTI

Author: Alicia Oberle, MD Educational Pearls: Recent study has shown risk factors for return included patients at high risk for resistance (nursing home, obstructive uropathy), patient where diagno...

23 Mars 20182min

Podcast #308: Ultrasound in Cardiac Arrest

Podcast #308: Ultrasound in Cardiac Arrest

Author: Aaron Lessen, M.D. Educational Pearls: There is currently debate within the medical community about what constitutes cardiac activity on ultrasound in the setting of cardiac arrest. A recent ...

21 Mars 20182min

Podcast #307: Guillain-Barre Syndrome

Podcast #307: Guillain-Barre Syndrome

Author: Peter Bakes, M.D. Educational Pearls: Rare disease with 1-2 patients out of 100,000. About 60% of patients report a preceding diarrheal illness and classically presents with an ascending mo...

19 Mars 20184min

Podcast #306: Tramadol Drama

Podcast #306: Tramadol Drama

Author: Nick Hatch, M.D. Educational Pearls Tramadol acts at multiple receptors and is a partial agonist at the mu opioid receptor, but also blocks reuptake of serotonin and norepinephrine throughou...

16 Mars 20183min

Podcast #305: Stuffers vs. Packers : Drug-Packet Ingestion

Podcast #305: Stuffers vs. Packers : Drug-Packet Ingestion

Author: Aaron Lessen, M.D. Educational Pearls A "stuffer" is a term for someone who hastily and conceals a bag of drugs orally/rectally/vaginally in an unplanned situation. A "packer" is someone who...

14 Mars 20183min

Podcast #304: Nostalgia

Podcast #304: Nostalgia

Author: Dylan Luyten, MD Educational Pearls Johannes Hoffer coined term Nostalgia in 1688 in his medical dissertation. Nostalgia was a formal medical diagnosis, and one that dates back to 17th...

12 Mars 20185min

Podcast #303: Lazarus Effect

Podcast #303: Lazarus Effect

Author: Dylan Luyten, M.D. Educational Pearls The Lazarus phenomenon is the delayed return of spontaneous circulation after cessation of CPR. A prospective study in Finland found 5 out of 840 patient...

9 Mars 20183min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
pojkmottagningen
kapitalet-en-podd-om-ekonomi
det-morka-psyket
dumforklarat
rss-vetenskapsradion-2
halsorevolutionen
rss-vetenskapsradion
rss-ufo-bortom-rimligt-tvivel
rss-spraket
rss-experimentet
sexet
medicinvetarna
vetenskapsradion
paranormalt-med-caroline-giertz
4health-med-anna-sparre
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli