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]
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 and chest pain, which is sharp and varies with position and movement and occasionally may feel like a heart attack, are common symptoms. [msdmanuals.com]
- 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]
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 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]
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]
- Sepsis
Despite the recovery of his sepsis, hypotension persisted because of cardiac tamponade. He achieved neutrophil-engraftment on day 32 after BMT. [nature.com]
Patients with bacterial pericarditis present more acutely unwell and with other features of bacterial sepsis. [rcemlearning.co.uk]
- Lymphadenopathy
The patient complained of intense chest pain, asthenia, arthralgia, low-grade fever, neck lymphadenopathy. [ncbi.nlm.nih.gov]
At this stage of the protocol, examinations aim to produce specific findings (for example, lymph biopsy in presence of lymphadenopathy, bronchoscopy in patients with pulmonary masses). [revespcardiol.org]
Respiratoric
- Pleural Effusion
The second course of chemotherapy with cytarabine and amsacrine was started after clinical improvement; 3 days later an acute pericarditis with a large pericardial effusion accompanied by a left pleural effusion developed. [ncbi.nlm.nih.gov]
Riddell IV 323 HIV and AIDS Daniel R Kaul Powel Kazanjian 331 42 Bioterrorism James C Pile 337 Fever in the Hospitalized Patient Daniel R Kaul 343 Pulmonary 349 Chronic Obstructive Pulmonary Disease 351 Asthma Michael P Lukela William F Bria II 361 Pleural [books.google.com]
Other chest sounds that are signs of fluid in the pericardium (pericardial effusion) or the lungs (pleural effusion) may also be heard. Your healthcare provider may also check for pulsus paradoxus. [cedars-sinai.edu]
- 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]
People with pericarditis may also develop dyspnea (shortness of breath) and fever. [verywell.com]
Consequently, patients often develop dyspnea because of discomfort associated with breathing. [pathwaymedicine.org]
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
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]
Its main clinical manifestations are: chest pain, pericardial friction rub and fever. [dialnet.unirioja.es]
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]
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]
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]
- 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]
Nevertheless, the retrosternal chest pain in acute pericarditis is very similar to that in STEMI. The combination of retrosternal chest pain and ST elevation on ECG explains why clinicians often confuse acute pericarditis and STEMI. [ecgwaves.com]
- 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
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]
However, data regarding manifestations, workup, and the management of acute pericarditis in the African American population is lacking. [cureus.com]
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]
Microbiology
- Staphylococcus Aureus
Staphylococcus aureus was the most frequent causative organism of purulent pericarditis and septic arthritis was the most common concurrent infection in the patients. [link.springer.com]
aureus was the responsible agent in four of five cases of purulent pericarditis; all five patients also had concurrent infection of the soft tissue, bone, lung, or other. [emedicine.com]
Staphylococcus aureus ) XII. [fpnotebook.com]
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]
Characteristics of ST elevations in STEMI ST elevation myocardial infarction (STEMI) causes localized ST elevations, meaning that there are ST elevations in a few leads which are anatomically neighbouring (so called contiguous leads ). [ecgwaves.com]
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]
- 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]
Pleura
- Pleural Effusion
The second course of chemotherapy with cytarabine and amsacrine was started after clinical improvement; 3 days later an acute pericarditis with a large pericardial effusion accompanied by a left pleural effusion developed. [ncbi.nlm.nih.gov]
Riddell IV 323 HIV and AIDS Daniel R Kaul Powel Kazanjian 331 42 Bioterrorism James C Pile 337 Fever in the Hospitalized Patient Daniel R Kaul 343 Pulmonary 349 Chronic Obstructive Pulmonary Disease 351 Asthma Michael P Lukela William F Bria II 361 Pleural [books.google.com]
Other chest sounds that are signs of fluid in the pericardium (pericardial effusion) or the lungs (pleural effusion) may also be heard. Your healthcare provider may also check for pulsus paradoxus. [cedars-sinai.edu]
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
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]
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]
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]
BACKGROUND AND OBJECTIVES: Epidemiologic data on hospitalizations for acute pericarditis are scarce. We sought to study the trends in these hospitalizations and outcomes in the USA over a 10-year period. [ncbi.nlm.nih.gov]
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]
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]
Pathophysiology: Pericardial Layers Parietal Pericardium Surrounds heart and limits end diastolic heart volume Closely adhered to the Great Vessel s and has minimal elasticity Pericardial sac Between the two pericardial layers Typically contains less [fpnotebook.com]
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]