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Acute Pericarditis
Pericarditis Acute

Images

WIKIDATA, CC BY-SA 3.0
WIKIDATA, CC BY-SA 4.0

Presentation

Chest pain was present in 96%, and fever was present in 56%. All children had electrocardiographic changes comprising ST and T-wave abnormalities. [ncbi.nlm.nih.gov]

In AMI, PR-depressions are rarely present. [en.wikipedia.org]

Entire Body System

  • Fever

    Cardiac complications are scarce in case of dengue fever. In this case report, clinical and especially ECG presentation are typical of acute pericarditis. This pericarditis is due to dengue fever. [ncbi.nlm.nih.gov]

    Fever may be present since this is an inflammatory process. There are several causes of acute pericarditis. [en.wikipedia.org]

  • Chills

    […] in the neck, shoulder, back, or abdomen Often increases with deep breathing and lying flat, and may increase with coughing and swallowing Can feel sharp and stabbing Is often relieved by sitting up and leaning or bending forward You may have fever, chills [nlm.nih.gov]

    If the effusion is purulent (caused by bacterial infection), a high fever, sweat, chills, and prostration also occur. [medical-dictionary.thefreedictionary.com]

    Other symptoms suggestive of a recent or concomitant viral illness, such as fatigue, fever, chills, or respiratory or gastrointestinal symptoms, might also be present in either pericarditis or myocarditis. [cfp.ca]

    The signs and symptoms of Pericarditis include, but are not limited to, the following: Low-grade fever, chills, sweating Chest pain; pain in chest increases on coughing or swallowing Dry cough Fatigue, anxiety Difficulty breathing, which gets worse especially [dovemed.com]

    Other symptoms may include fevers and chills, sweats, shortness of breath, and difficulty swallowing. When pericarditis is due to infection, the symptoms tend to arise quickly while inflammation due to chronic diseases is more gradual in onset. [medicinenet.com]

  • Malaise

    The pain is relieved by leaning forward and is made worse by lying supine. [1,2] Fever, malaise, and myalgia On going inflammation with release of cytokines responsible for these symptoms.[1,2] Shortness of breath Will be prominent in cardiac tamponade [explainmedicine.com]

    Symptoms Exercise intolerance Fatigue Prodrome (if infectious) Fever Malaise Myalgias VI. [fpnotebook.com]

    Common associated signs and symptoms include low-grade intermittent fever, dyspnoea, cough, malaise, myalgia and occasionally hiccoughs. The medical history often reveals symptoms suggestive of viral infection. [escardio.org]

    Signs and Symptoms Clinical Symptoms Symptoms are often vague and their onset is insidious; they include malaise, fatigue, and decreased exercise tolerance. [clevelandclinicmeded.com]

  • Weight Loss

    In tuberculosis pericarditis, fever, night sweats, and weight loss tend to be common (80-percent). Be aware that individuals with pericarditis may also present with a primary symptom of acute abdominal pain. [ceufast.com]

Respiratoric

  • Dyspnea

    A 65-year-old female patient was admitted to our hospital with the symptoms of chest pain, dyspnea and fatigue. She had undergone a tooth extraction three months before. She took no medication. Echocardiography revealed pericardial effusion. [ncbi.nlm.nih.gov]

    References: [3] [4] [2] Clinical features Acute pericarditis Low-grade intermittent fever, tachypnea, dyspnea, nonproductive cough Chest pain : often sharp, pleuritic ; improves on sitting and leaning forward Pericardial friction rub : high-pitched scratching [amboss.com]

    Consequently, patients often develop dyspnea because of discomfort associated with breathing. [pathwaymedicine.org]

    The patient is told to report symptoms of recurrence, including fever, chest pain, and dyspnea. [medical-dictionary.thefreedictionary.com]

Course

  • Subacute Clinical Course

    Hospital admission should be reserved for patients with high fever, subacute clinical course, cardiac tamponade, severe effusion, myocardial involvement, and for immunodepressed patients or those who are receiving anticoagulant treatment. 20 Pharmacological [revespcardiol.org]

Cardiovascular

  • Chest Pain

    Recent-onset chest pain in the presence of (sinus) bradycardia is considered to be associated with an acute ischemic syndrome rather than acute pericarditis. [ncbi.nlm.nih.gov]

  • Pericardial Friction Rub

    Its main clinical manifestations are: chest pain, pericardial friction rub and fever. [dialnet.unirioja.es]

    Diagnosis is based on the recognition of two characteristic findings (pericardial chest pain, pericardial friction rub, new ECG changes or new pericardial effusion). [ncbi.nlm.nih.gov]

    friction rub 0 references Identifiers Freebase ID /m/0c9kg4 1 reference stated in Freebase Data Dumps publication date 28 October 2013 UMLS CUI C0155679 0 references Sitelinks Wikipedia (8 entries) edit arwiki التهاب التامور الحاد cawiki Pericarditis [wikidata.org]

  • Tachycardia

    Acute pericarditis is almost invariably associated with sinus tachycardia. Recent-onset chest pain in the presence of (sinus) bradycardia is considered to be associated with an acute ischemic syndrome rather than acute pericarditis. [ncbi.nlm.nih.gov]

    The most common presentation of symptomatic pericarditis consisted of chest pain, dyspnea, tachycardia, and tachypnea. Electrocardiogram (EKG) findings included diffuse ST elevation (15 percent) and sinus tachycardia (41 percent). [cureus.com]

    Paroxysmal tachycardia and the effect of stimulation of the vagus nerves by pressure. Heart 1913:5:93 2. Wolff L, Parkinson J, White PD. Bundle branch block with short PR interval in healthy young people prone to paroxysmal tachycardia. [books.google.com]

  • Retrosternal Chest Pain

    After 90 hours of 5-fluorouracil infusion, he developed severe retrosternal chest pain. Electrocardiography showed signs of acute pericarditis and was managed with ibuprofen and 5-fluorouracil was discontinued. [ncbi.nlm.nih.gov]

    HPI: A 22 year-old male presented to the emergency department with a chief complaint of retrosternal chest pain that started yesterday. He described the pain as a constant, sharp and pleuritic. [jetem.org]

    Symptomology The prototypical symptom of acute pericarditis is retrosternal chest pain which may also refer to the back and shoulders. [pathwaymedicine.org]

  • Pericardial Disorder

    Pericardial Disorders The pericardium is a membrane, or sac, that surrounds your heart. It holds the heart in place and helps it work properly. Problems with the pericardium include Pericarditis - an inflammation of the sac. [icdlist.com]

Skin

  • Night Sweats

    Immunocompromised or human immunodeficiency virus (HIV)‑positive patients are at increased risk. 4 Nonspecific symptoms such as dyspnea, fever, chills, and night sweats develop slowly, and a friction rub or chest pain is often absent. [clevelandclinicmeded.com]

    In tuberculosis pericarditis, fever, night sweats, and weight loss tend to be common (80-percent). Be aware that individuals with pericarditis may also present with a primary symptom of acute abdominal pain. [ceufast.com]

  • Increased Sweating

    Side effects of corticosteroids include: weight gain mood swings increased sweating Other treatments and measures Treatment for pericarditis is different if it is not caused by a viral infection. [your.md]

Workup

However, data regarding manifestations, workup, and the management of acute pericarditis in the African American population is lacking. [cureus.com]

Multimodality cardiovascular imaging and diagnostic work-up 4.1 Multimodality imaging 4.1.1 Chest X-ray 4.1.2 Echocardiography 4.1.6 Cardiac catheterization 4.1.7 Multimodality imaging 4.2 Proposal for a general diagnostic workup 5. [escardio.org]

A routine fever workup was negative. She was discharged the following day. The patient was readmitted three months later with recurrent pleuritic chest pain, which did not improve with resumption of NSAID therapy. [the-hospitalist.org]

However, i f the troponin is raised the patient should be considered to have myopericarditis and as this is a feature of poor prognosis further inpatient workup should be considered. [rcemlearning.co.uk]

X-Ray

  • Pericardial Effusion

    The aim of this study was to identify clinical indicators for SIDs in patients admitted for acute pericarditis with pericardial effusion. [ncbi.nlm.nih.gov]

    Cardiac tamponade is accumulation of enough fluid in the pericardial space --- pericardial effusion --- to cause serious obstruction to the inflow of blood to the heart. [en.wikipedia.org]

QT, RR, ST Intervals

  • ST Elevation

    A 64-year-old woman was admitted because of persistent chest pain and ST-elevation in the precordial and inferior leads on electrocardiogram. [ncbi.nlm.nih.gov]

    Significant findings: The ECG shows diffuse ST- elevation. The patient also has mild PR-depression, most notably in the inferior and lateral leads. The patient also has minimal PR elevation in lead aVR. [jetem.org]

    Same frequencies observed with TnI ≥1.5 ng/ml ST elevation for detecting patients with raised TnI ST elevation present in 67% of patients with detectable TnI and 62% of those without. [bestbets.org]

    Pericarditis can cause localised ST elevation but there should be no reciprocal ST depression (except in AVR and V1). STEMI, like pericarditis, can also cause concave up ST elevation. Only STEMI causes convex up or horizontal ST elevation. [lifeinthefastlane.com]

  • ST Elevation in All Leads

    In pericarditis four stages can be distinguished on the ECG: stage I: ST elevation in all leads. [en.ecgpedia.org]

T Wave

  • Flattened T Wave

    Stages 2, 3, and 4 ECG findings consist of ST-segment normalization and T wave flattening, T wave inversion, and normalization of T waves, respectively. [cfp.ca]

    Stage 1 – widespread STE and PR depression with reciprocal changes in aVR (occurs during the first two weeks) Stage 2 – normalisation of ST changes; generalised T wave flattening (1 to 3 weeks) Stage 3 – flattened T waves become inverted (3 to several [lifeinthefastlane.com]

Other ECG Findings

  • Electrocardiogram Change

    Patients were eligible if they were >18 years of age presenting with their first episode of acute pericarditis (diagnosed by observing two of typical chest pain, friction rub, suggestive electrocardiogram changes, new/worsening pericardial effusion). [2minutemedicine.com]

    A widespread T wave inversion is observed on the electrocardiogram, without the appearance of Q waves Stage 4 Acute Pericarditis, Stage 4 Electrocardiogram changes return to normal. [en.my-ekg.com]

Treatment

Pharmacological treatment should include anti-inflammatory drugs in combination with treatment for hyperthyroidism. The specific pathophysiological link between the two conditions is still to be elucidated. [ncbi.nlm.nih.gov]

[…] first-choice treatment for acute pericarditis. [doi.org]

Prognosis

The prognosis is highly dependent on a correct and precocious diagnosis (etiology included) and therapy. [ncbi.nlm.nih.gov]

The prognosis of pericardial diseases is essentially determined by the cause. [doi.org]

Pericardial syndromes 3.1 Acute pericarditis 3.1.1 Clinical management and therapy 3.1.2 Prognosis 3.2 Incessant and chronic pericarditis 3.3 Recurrent pericarditis 3.3.1 Therapy 3.3.2 Prognosis 3.4 Pericarditis associated with myocardial involvement [escardio.org]

Etiology

Nevertheless, there is a lack of prospective studies that have evaluated the specific risk according to different etiologies. [ncbi.nlm.nih.gov]

Overview Pericarditis can be caused by both infectious and noninfectious etiologies. [pathwaymedicine.org]

Most studies have shown that specific underlying etiology is found in only 17 percent of the cases and more than 80 percent of the cases are secondary to infectious etiology or unknown causes [7-9]. [cureus.com]

Epidemiology

Epidemiology, aetiology and classification of pericardial diseases 2.1 Epidemiology 2.2 Aetiology 3. [escardio.org]

Recent findings The cause of pericardial diseases is varied according to the epidemiologic background, patient population, and clinical setting. [doi.org]

Though epidemiologic studies are lacking, acute pericarditis is recorded in 0.1 to 0.2 percent of hospitalized patients and in five percent of the patients admitted to the emergency department with non-ischemic chest pain [1]. [cureus.com]

"Epidemiology and Causes of Heart Failure." Retrieve April 4, 2014 from UpToDate.com [ceufast.com]

Knowledge of this basic epidemiologic fact is essential for the development of a rational management protocol that, on the one hand, avoids the unnecessary use of invasive pericardial diagnostic procedures in patients with idiopathic pericarditis and [revespcardiol.org]

Pathophysiology

The specific pathophysiological link between the two conditions is still to be elucidated. [ncbi.nlm.nih.gov]

Pathophysiology The pericardium is a fibrous sac surrounding the heart consisting of two layers: a thin visceral layer attached to the pericardium and a thicker parietal layer. [unboundmedicine.com]

Pathophysiology The initiating event results in a chronic inflammatory pericardial process, resulting in fibrinous scarring and occasionally calcification of the pericardium ( Figure 10 ). [clevelandclinicmeded.com]

However, the pathophysiologic process leading to cTnI release in myopericarditis is distinctly different from that in patients with acute coronary syndromes, and it is uncertain whether a cTnI elevation carries the same prognostic value. [onlinejacc.org]

Prevention

A longer course of colchicine is recommended for the prevention of recurrence of the disease. The use of glucocorticoids should be avoided due to the associated risk of recurrence. Exercise and physical activity are harmful during pericarditis. [ncbi.nlm.nih.gov]

The aim of the present study was to verify the safety and efficacy of colchicine as an adjunct to conventional therapy for treatment of the first episode of acute pericarditis and for prevention of recurrences. [doi.org]

An additional medicine called colchicine has been shown to prevent prolonged symptoms. Colchicine has also been shown to prevent pericarditis from happening again. [thesgem.com]

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