Medical Surgical Pericarditis #3

Question

A client arrives at the emergency department stating they “…may be having a heart attack”. Which clinical manifestation is an important finding to report to the healthcare provider to potentially rule out a myocardial infarction and support the potential diagnosis of acute pericarditis?

Answers

  1. Temperature of 100.1 F
    • Rationale:

      This answer is correct because a fever is a common symptom of acute pericarditis whereas a myocardial infarction may produce a low grade fever later due to the inflammatory process associated with myocardial death. Tachycardia, chest pain, and shortness of breath are associated with both pericarditis and myocardial infarction (MI).

  2. Heart rate of 102 bpm
    • Rationale:

      This answer is not correct because tachycardia is associated with both pericarditis and myocardial infarction (MI). A fever is a common symptom of acute pericarditis whereas a myocardial infarction may produce a low grade fever later due to the inflammatory process associated with myocardial death.

  3. Reports of chest pain
    • Rationale:

      This answer is not correct because chest pain is associated with both pericarditis and myocardial infarction (MI). A fever is a common symptom of acute pericarditis whereas a myocardial infarction may produce a low grade fever later due to the inflammatory process associated with myocardial death.

  4. Shortness of breath
    • Rationale:

      This answer is not correct because shortness of breath is associated with both pericarditis and myocardial infarction (MI). A fever is a common symptom of acute pericarditis whereas a myocardial infarction may produce a low grade fever later due to the inflammatory process associated with myocardial death.

Overview

A fever is a common symptom of acute pericarditis. A myocardial infarction may produce a low grade fever but some time later due to the inflammatory process associated with myocardial death.

Explanation

Learning Outcomes

Pericarditis is the inflammation of the membranous sac that surrounds the heart. There is acute pain associated with the inflammation of the pericardium. Pericarditis causes severe pain with rapid onset that worsens with breathing, coughing, and/or changing positions. Leaning forward can help alleviate the pain. Such pain prevents the ability to help respiratory efforts. It worsens as excessive accumulation of fluid in the pericardial sac occurs. The result is decreased stroke volume and compression of the heart. The client often fears they are experiencing a heart attack. Another very common finding with pericarditis is a pleural friction rub. A pleural friction rub has a scratching, grating sound similar to leather rubbing against leather. A fever is a common symptom of acute pericarditis. A myocardial infarction may produce a low grade fever but some time later due to the inflammatory process associated with myocardial death.

Test Taking Tip

When studying, really focus on what is unique and different about a disease process.

Video Rationale