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(1147)

Podcast #295: UTI

Podcast #295: UTI

Author: Sam Killian, M.D. Educational Pearls Traditionally, UTI diagnosis has been dependent on urine culture, urinalysis and clinical symptoms. But a recent study casts some doubt on the utility of ...

26 Jan 20184min

Podcast #294: Rhabdomyolysis

Podcast #294: Rhabdomyolysis

Author: Michael Hunt, M.D. Educational Pearls Rhabdomyolysis is caused by the destruction of skeletal muscle that leads to the release of myoglobin, which causes renal failure. It presents with pain ...

22 Jan 20183min

Podcast #293: Transient Global Amnesia

Podcast #293: Transient Global Amnesia

Author: Sam Killian, M.D. Educational Pearls Transient global amnesia is a paroxysmal, transient memory issue. Remote and immediate memory is preserved, but new memories cannot be made. Patients will...

19 Jan 20184min

Podcast #292: Hypercalcemia

Podcast #292: Hypercalcemia

Author: John Winkler, M.D. Educational Pearls Normally, the parathyroid is the master regulator of serum Ca levels. It secretes PTH, which stimulates calcium uptake from the bone and gut. Causes of ...

17 Jan 20182min

Podcast #291: Cincinnati Stroke Scale

Podcast #291: Cincinnati Stroke Scale

Author: Nick Hatch, M.D. Educational Pearls The Cincinnati Stroke Scale uses 3 measures to screen for ischemic stroke. The measures are: facial asymmetry, speech quality and arm drift. This scale is ...

15 Jan 20182min

Podcast #290: The Biochemistry of DKA

Podcast #290: The Biochemistry of DKA

Author: Dave Rosenberg, M.D. Educational Pearls DKA commonly causes hyperkalemia, leading to peaked T-waves on ECG. However, DKA causes hypokalemia at the same time. In DKA, glucose cannot be taken i...

12 Jan 20186min

Podcast #289: Cannabinoid Hyperemesis

Podcast #289: Cannabinoid Hyperemesis

Author: Dylan Luyten, M.D. Educational Pearls Cannabinoid Hyperemesis syndrome is a relatively new diagnosis that presents with vomiting and abdominal pain without a clear etiology in the setting of ...

10 Jan 20183min

Podcast #288: Diarrhea

Podcast #288: Diarrhea

Author: Peter Bakes, M.D. Educational Pearls Chronic diarrhea is defined as 3 or more loose, watery stools lasting more than 2-3 weeks. Look for clues in the history, including travel (could suggest...

8 Jan 20187min

Populärt inom Vetenskap

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