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2.1
Familial Pericarditis

Presentation

Focuses on aspects of pathophysiological processes, clinical presentations, screening tests, prognostic implications and novel therapeutic approaches. [books.google.com]

Typical presentations of the disease include episodes of fever, abdominal pain and joint pains. Chest pain is a less common presentation. [um.edu.mt]

The case Presented by: Alexandros Protonotarios MD, Adalena Tsatsopoulou MD and Aris Anastasakis MD, PhD Case presentation A 43 year-old man presented due to his 14-year-old daughter’s sudden death. Post mortem diagnosis was myocarditis. [escardio.org]

(in 85% of patients) Absent (unless pericarditis is present) Rare; a pleural friction rub is present in 3% of patients S 3 sound, pulmonary congestion Absent May be present Absent Table 4. [aafp.org]

Symptoms usually begin in most patients between preschool and adolescence, but this disease is present throughout the patient's life. [autoinflammatory.org]

Cardiovascular

  • Pericardial Friction Rub

    A pericardial friction rub is audible at some point in about 85% of patients with acute pericarditis, may have up to three components per cardiac cycle, is high-pitched, and is described as rasping, scratching, or grating ( Chap. 267 ). [accessmedicine.mhmedical.com]

    […] a pericardial friction rub and thus allows differentiation from a pleural rub. [aafp.org]

    friction rub, typical electrocardiographic changes, and pericardial effusion. [utswim.wordpress.com]

    A pulsus paradoxus in patients with a pericardial effusion helps distinguish those with cardiac tamponade from those without. [ 7 ] Pericardial friction rub: the most important physical sign of acute pericarditis. [patient.info]

    It was managed with small doses of prednisone ( Discussion RP is a chronic disease characterized by recurrent episodes of fever, chest pain, pericardial friction rubs, electrocardiographic changes, and pericardial effusion. [pediatrics.aappublications.org]

  • Retrosternal Chest Pain

    Pericarditis was diagnosed when patients sustained attacks of pleuritic retrosternal chest pain and had typical findings in the electrocardiogram, echocardiogram or chest radiogram. [ncbi.nlm.nih.gov]

    Features That Differentiate Acute Pericarditis from Myocardial Ischemia or Infarction and Pulmonary Embolism Symptom and clinical finding Acute pericarditis Myocardial ischemia or infarction Pulmonary embolism Chest pain Location Retrosternal Retrosternal [aafp.org]

Workup

The objective of this article is to review the etiology, workup, and treatment for this disease, especially new, emerging therapeutic options. [dovepress.com]

QT, RR, ST Intervals

  • ST Elevation

    Stage II: normalization of the ST and PR segments Stage III: diffuse T-wave inversions Stage IV: normalization of the T-waves ST-elevation MI v Pericarditis ST-segments are concave (as opposed to the convex or dome-shaped ST-elevations seen in MI) Ratio [utswim.wordpress.com]

    Note the ST elevation in multiple leads with slight reciprocal ST depression in aVR. [en.wikipedia.org]

    Recurrent pericarditis usually presents with symptoms akin to the acute attack, including chest pain, fever, pericardial rub, typical electrocardiographic findings (i.e. diffuse ST elevations and PR depressions), pericardial effusion and, infrequently [clinicalcorrelations.org]

    He described positional chest pain, and was found to have diffuse ST elevations on ECG, along with moderate pericardial effusion on echocardiogram and elevated inflammatory markers. He was initially treated with NSAIDs and colchicine with relief. [acc.org]

    In the natural evolution, four stages are described: - Stage I (80% of cases): concave up ST with anterior and inferior elevation. [scielo.br]

Treatment

To the Editor: We read with great interest the article by Adler et al regarding colchicine treatment for recurrent pericarditis. 1 The authors described 51 patients from Israel, Spain, and the United States. [circ.ahajournals.org]

During colchicine treatment, only 7 of the 51 patients had recurrences. In addition, the symptom-free period was significantly longer after starting colchicine treatment: 3.1 months vs 43 months. [clevelandclinicmeded.com]

[…] discontinuation of treatment. [dovepress.com]

Prognosis

Prognosis is excellent with treatment. Familial Mediterranean fever (FMF) is a disease of people with genetic origins in the Mediterranean basin, predominantly Sephardic Jews, North African Arabs, Armenians, Turks, Greeks, and Italians. [msdmanuals.com]

The prognosis depends on many factors, such as the severity of the underlying condition; although in most cases with appropriate treatment, it is good Non-Infectious Pericarditis, in some cases, can become a chronic condition. [dovemed.com]

The course of these manifestations varies widely, but it can associate with poor prognosis in some cases such as with pulmonary hypertension. [avicennajmed.com]

One study showed myocardial involvement may portent a better prognosis in terms of recurrence risk. [acc.org]

Indicators of poor prognosis of acute pericarditis. Circulation. 2007;115:2739-2744. [ Links ] Imazio M, Brucato A, Maestroni S, Cumetti D, Dominelli A, Natale G, Trinchero R. [scielo.br]

Etiology

Incidence of specific etiology and role of methods for specific etiologic diagnosis of primary acute pericarditis. Am J Cardiol. 1995;75(5):378–382. 13. Ginzton LE, Laks MM. [aafp.org]

R5 In conclusion, we generally accept that genetic studies of FMF should be carried out in patients with recurrent episodes of pericarditis of unknown etiology, especially patients of Mediterranean origin. [circ.ahajournals.org]

Evidence of Autoimmune Etiology Multiple lines of evidence suggest an immune-mediated etiology to IRP. [acc.org]

Etiology The cause of pericarditis is very often investigated in the acute phase, and among the different publications, it is difficult to distinguish etiological research between acute and recurrent pericarditis. 12 A recent prospective study on 933 [dovepress.com]

Consider rheumatic fever as an etiology in any child with pericarditis. However, this disease is not a demonstrated cause of constrictive pericarditis. [emedicine.medscape.com]

Epidemiology

[…] certificates, autopsies, and the role of the medical examiner Presents 25 case studies from the author’s experience to illustrate concepts, including cardiac trauma, vascular abnormalities, specific cardiopathic disorders, and toxic, physical, technical, epidemiological [books.google.com]

Epidemiology [ 1 ] Small pericardial effusions are often asymptomatic and pericardial effusion has been found in 3.4% of general autopsy studies. [ 1 ] Studies in the pre-highly active antiretroviral therapy (HAART) era reported an incidence of 11% of [patient.info]

Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention [books.google.ro]

[…] with colchicine-resistant FMF and in two additional autoinflammatory recurrent fever syndromes: mevolonate kinase deficiency (hyper- immunoglobulin D syndrome, or HIDS ) and tumor necrosis factor receptor-associated periodic syndrome ( TRAPS ). [19] Epidemiology [en.wikipedia.org]

Pathophysiology

Focuses on aspects of pathophysiological processes, clinical presentations, screening tests, prognostic implications and novel therapeutic approaches. [books.google.com]

In this article, In this article, we will discuss the incidence, pathophysiology, and prognosis of the various cardiac manifestations affecting FMF patients. [avicennajmed.com]

They are most often “idiopathic”, with a still incompletely understood pathophysiology, involving autoimmunity and autoinflammation of various degrees, and usually set off by microbacteriological or postinjury triggers. [dovepress.com]

Van Sickle Pathophysiology of Osteochondrosis Osteochondrosis of the Cervical Intervertebral Joints.Since a large number of organisms can produce pneumonia, a physician can often arrive at a more rapid microbiological diagnosis if the pathogens are grouped [tihalipijeweduzemu.xpg.uol.com.br]

Prevention

Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]

Prevention conference V: Beyond secondary prevention : Identifying the high-risk patient for primary prevention: executive summary. [books.google.ro]

Shortly thereafter colchicine use has been expanded to the primary prevention of recurrences in patients with a first episode of pericarditis depicting similarly good results. [ncbi.nlm.nih.gov]

This in turn prevents intracellular movement and secretion of proinflammatory substances resulting in less inflammation and its sequelae. [clinicalcorrelations.org]

[…] recurrent pericarditis, in view of its ability to prevent polyserositis in familial Mediterranean fever. [clevelandclinicmeded.com]

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