Presentation
Abstract Pericardial disorders occurring in connective tissue diseases are not uncommon and may present as acute or chronic pericarditis with or without an effusion. [ncbi.nlm.nih.gov]
Rheumatology Reports, 6 (1). https://doi.org/10.4081/rr.2014.5450 Main Article Content Abstract We report a case of a 25-year-old lady who presented to our department with complaints of easy fatigability and shortness of breath since one week. [pagepress.org]
A pericardial friction rub from pericarditis may be present. Ewart’s sign is dullness to percussion at the left lung base due to compressive atelectasis from a large pericardial effusion. [healio.com]
Presentation of CaseA 42-year-old man was admitted to the hospital because of a question of constrictive pericarditis.He was well until four years previously, when an x-ray film of the chest, obtained elsewhere, revealed mediastinal enlargement. [nejm.org]
Posteriorly, a pericardial effusion is located anterior to the descending thoracic aorta, whereas a pleural effusion is present posterior to the aorta ( Fig. 24.13 ). [thoracickey.com]
Entire Body System
- Fever
Fever is a common symptom of acute pericarditis. Treatment depends on the cause. [leehealth.org]
Fever is a common symptom of acute pericarditis. Your doctor may use a physical exam, imaging tests, and heart tests to make a diagnosis. Treatment depends on the cause. [tabletwise.com]
Fever is a common symptom of acute pericarditis. Your doctor may use a physical exam, imaging tests, and heart tests to make a diagnosis. Treatment depends on the cause. NIH: National Heart, Lung, and Blood Institute [medlineplus.gov]
- Weakness
[…] pulse Decreased heart sounds Distended or bulging veins Bluish skin color, or cyanosis Severe anxiety or panic Most symptoms of chronic constrictive pericarditis include: Fatigue Weakness Shortness of breath Weight loss Loss of appetite Liver enlargement [leehealth.org]
The symptoms of constrictive pericarditis include: breathing difficulty that develops slowly and becomes worse fatigue a swollen abdomen chronic, severe swelling in the legs and ankles weakness a low-grade fever chest pain When the covering of your heart [healthline.com]
Rarely, the pericardium is missing at birth or has defects, such as weak spots or holes. These defects can be dangerous because the heart or a major blood vessel may bulge (herniate) through a hole in the pericardium and become trapped. [msdmanuals.com]
The affected person may experience difficulty in breathing and may be weak, anxious, and depressed. The skin may be pale or bluish, and the person may be feverish and delirious. [britannica.com]
Aortic dissection from mural weakness caused by GCA has been reported. Blindness can occur if GCA isn’t treated promptly. In rare cases like my mother’s, PMR causes cardiac manifestations. [americannursetoday.com]
- Ascites
[…] sounds Distended or bulging veins Bluish skin color, or cyanosis Severe anxiety or panic Most symptoms of chronic constrictive pericarditis include: Fatigue Weakness Shortness of breath Weight loss Loss of appetite Liver enlargement Distended neck veins Ascites [leehealth.org]
Analysis of the fluid via pericardiocentesis is different than analyzing fluid from a pleural effusion or ascites. [healio.com]
Ascites. Untreated coronary artery disease. Elderly age. New York Heart Association (NYHA) class IV heart failure symptoms. Post-radiation pericarditis. Myocardial fibrosis. [patient.info]
Similar physical findings are present in patients with constrictive pericarditis although ascites is more common in patients with constrictive pericarditis. Figure 24.20. [doctorlib.info]
Patients with constrictive pericarditis present with dyspnea, peripheral edema, ascites, pleural effusion, fatigue, or anasarca. Jugular venous pressure is almost always elevated with typical rapid “y” descent ( Fig. 24.17 ). [thoracickey.com]
- Weight Loss
loss Loss of appetite Liver enlargement Distended neck veins Ascites, or the accumulation of fluid in the abdomen Edema, or the accumulation of fluid in the extremities Chest pain that accompanies pericarditis may be worsened by lying down, coughing, [leehealth.org]
The symptoms of lupus-induced vasculitis that you may experience can vary depending upon which tissues are involved, but may include: Fever Feeling ill Poor appetite Weight loss Headache Blurry vision Seizures Strokes Behavioral disturbances [resources.lupus.org]
Signs and symptoms of GCA include headache, shoulder and hip pain, jaw pain after chewing, fever, blurred vision, scalp tenderness, cough, throat pain, tongue pain, weight loss, and stroke. [americannursetoday.com]
A study of 233 patients found that fever, night sweats, weight loss, elevated serum globulin, and normal peripheral white blood cell count were independent predictors of tuberculous pericarditis and could be used in a clinical decision tool for making [aafp.org]
- Hodgkin Lymphoma
lymphoma, or Hodgkin lymphoma Trauma or puncture wound near the heart Accumulation of blood in the pericardium after an injury or surgery Underactive thyroid (hypothyroidism) Viral, bacterial, fungal, or parasitic infections Waste products in the blood [utswmed.org]
lymphoma or Hodgkin's disease cancer of the pericardium or heart radiation therapy for cancer waste products in the blood due to kidney failure hypothyroidism viral infections bacterial infections fungal infections parasitic infections Risk Factors for [tabletwise.com]
’s lymphoma or Hodgkin’s disease Spreading of cancer through other parts like breast, lung or blood Because of Pericardial cancer Because of some drugs you might have been prescribed for other cardiac ailments Idiopathic pericarditis – Undetermined causes [medanta.org]
Miscellaneous causes include malignancy, of which lung cancer, breast cancer and Hodgkin’s lymphoma are the most common. Theoretically, any malignancy can cause a pericardial effusion. [healio.com]
Respiratoric
- Pleural Effusion
Two-dimensional ultrasonographic imaging of pleural effusion is also helpful in planning for a thoracentesis to locate the optimal puncture site. Pleural effusion on the left side allows cardiac imaging from the back ( Fig. 24.14 ). Figure 24.5. [thoracickey.com]
Analysis of the fluid via pericardiocentesis is different than analyzing fluid from a pleural effusion or ascites. [healio.com]
Cardiac CT and MRI will also aid in differentiating an effusion from pericardial fat, pericardial cysts and pleural effusions, all of which can mimic a pericardial effusion. [clevelandclinicmeded.com]
This diagnosis should be considered in patients older than age 50 who have pericarditis or idiopathic pericardial or pleural effusions. [americannursetoday.com]
Gastrointestinal
- Diarrhea
Other symptoms may include: Fever Fatigue Muscle aches Shortness of breath Nausea, vomiting, and diarrhea (if you have a virus) When there’s no inflammation of the sac, there are often no symptoms. [webmd.com]
Christine Jellis, MD, PhD: Diarrhea in the setting of colchicine may reflect colchicine toxicity. [my.clevelandclinic.org]
- Loss of Appetite
Loss of appetite Liver enlargement Distended neck veins Ascites, or the accumulation of fluid in the abdomen Edema, or the accumulation of fluid in the extremities Chest pain that accompanies pericarditis may be worsened by lying down, coughing, breathing [leehealth.org]
Cardiovascular
- Heart Disease
Zilberman, MD Title(s) : Director, Pediatric Echocardiology and Fetal Cardiology; Director, Adult Congenital Heart Disease Clinic; Pediatric Cardiologist; Associate Professor, Tufts University School of Medicine Department(s) : Pediatrics, CardioVascular [tuftsmedicalcenter.org]
[…] title=Category:Pericardial_disorders&oldid=833869875 " Categories : Heart diseases Hidden categories: Commons category link is on Wikidata [en.wikipedia.org]
T he evaluation of pericardial disorders is of increasing importance in the management of patients with congenital heart disease. [thoracickey.com]
[…] such as syphilis, rheumatic heart disease, tuberculosis, amebiasis (amebic dysentery), or histoplasmosis. [britannica.com]
- Palpitations
Large, serious pericardial effusions, or smaller ones that develop quickly, may cause symptoms that include: Shortness of breath Palpitations (sensation that the heart is pounding or beating fast) Light-headedness or passing out Cool, clammy skin A pericardial [webmd.com]
Eventually I again experience bouts of palpitations and weight in the chest as if it had a band around the thorax and making it difficult to exhale. These symptoms usually last up to 20 minutes. [my.clevelandclinic.org]
[…] are present, they can include: Anxiety Chest pain, pressure, or discomfort, relieved by sitting up or leaning forward and worsened by lying flat Feeling of abdominal fullness Confusion Cough Shortness of breath Fainting (syncope) Lightheadedness Heart palpitations [utswmed.org]
Chest pain; pain in chest increases on coughing or swallowing Dry cough Fatigue, anxiety Difficulty breathing, which gets worse especially while reclining or lying down, but gets better on sitting, leaning forward or standing Rapid heart rate, heart palpitations [dovemed.com]
Cardiovascular symptoms include chest pain, pressure or discomfort, syncope, light-headedness and palpitations. Many patients are asymptomatic until the disease is advanced (up to 2 L of fluid can build up). [patient.info]
- Cyanosis
Excessive fluid aound heart Dull-chest pain Low-grade fever Most symptoms of cardiac tamponade include: Rapid heartbeat Difficulty breathing Severe drop in blood pressure Weak pulse Decreased heart sounds Distended or bulging veins Bluish skin color, or cyanosis [leehealth.org]
Other frequent symptoms are pulsus paradoxus, pericardial friction sounds, tachycardia, tachypnea, weakened peripheral pulses, edema, cyanosis. Cardiac tamponade is seen in Video 1. Video 1. Cardiac tamponade. [ecgwaves.com]
Liver, Gall & Pancreas
- Hepatomegaly
Additionally, there may be pulsatile hepatomegaly (in as many as 70% of patients), reduced apical impulse and a pericardial 'knock' (early diastolic sound). Pulsus paradoxus, a finding in cardiac tamponade, is uncommon [ 2 ]. [patient.info]
Psychiatrical
- Fear
I feared she was dying. Follow-up echocardiography showed a small pericardial effusion and lab tests revealed an elevated sedimentation rate (ESR), indicating inflammation; her hematocrit and hemoglobin values wre below normal. [americannursetoday.com]
3) I think sometimes for fear or somatization I get confused and I have discomforts(after 1-2 weeks of a flare up) that I would say is more anxiety than real pains from Pericarditis...Is this frequent and normal. Thanks for your answers. [my.clevelandclinic.org]
Neurologic
- Confusion
[…] pleuritic, consequent to accompanying pleural inflammation (i.e., sharp and aggravated by inspiration and coughing), but sometimes it is steady, constricting, radiates into either arm or both arms, and resembles that of myocardial ischemia; therefore, confusion [accessmedicine.mhmedical.com]
It may be confused with other heart conditions like: restrictive cardiomyopathy, which occurs when the heart chambers can’t fill with blood because of stiffness in the heart cardiac tamponade, which occurs when fluid between the heart muscle and the pericardium [healthline.com]
Increased stress can cause a severe chain reaction of symptoms in the body, which can confuse the immune system into thinking that the abnormal chemical process is an attack on the body. [pericarditispain.info]
The condition doesn’t always cause symptoms, but when they are present, they can include: Anxiety Chest pain, pressure, or discomfort, relieved by sitting up or leaning forward and worsened by lying flat Feeling of abdominal fullness Confusion Cough Shortness [utswmed.org]
Other symptoms include fatigue, hiccoughs, anxiety and confusion. Attention should be given to any history of specific antecedent conditions (eg, cardiac surgery, renal failure, radiation treatment, malignancy, TB). [patient.info]
- Agitation
The most common co-existing conditions in Pericarditis and stress are: Depression Pain Agitation Hypertension Hypotension Diabetes Schizophrenia Blood pressure Post-traumatic stress disorder Bipolar I disorder The most common medications used are: Seroquel [pericarditispain.info]
Appearance of agitated saline in the pericardial sac ( arrows ). If agitated saline is seen in any of cardiac chambers, surgical consultation should be obtained immediately before any attempt to remove pericardiocentesis needle or catheter. [doctorlib.info]
The position of the pericardiocentesis needle can be checked by imaging with administration of agitated saline. Figure 24.11 demonstrates contrast (arrows) in the pericardial space, not in the right ventricle. [thoracickey.com]
[…] progressive limitation of diastolic ventricular filling, resulting in lowered cardiac output. 18,19 Signs and Symptoms Symptoms Symptoms resulting from decreased cardiac output and congestion include dyspnea, chest discomfort, weakness, restlessness, agitation [clevelandclinicmeded.com]
- Irritability
Phrenic nerve irritation can cause hiccups. With a small effusion, the physical examination is unremarkable. [clevelandclinicmeded.com]
- Asthenia
Signs and symptoms of PMR include severe, symmetrical pain and stiffness in the neck, shoulder, and pelvic girdles, along with painful restriction of motion, malaise, anorexia, weight loss, moderate fever, asthenia, difficulty rising from the bed and [americannursetoday.com]
Workup
Therefore, further workup for underlying autoimmune disease, systemic inflammatory disease, or infection is necessary. [mdedge.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]
Pleura
- Pleural Effusion
Two-dimensional ultrasonographic imaging of pleural effusion is also helpful in planning for a thoracentesis to locate the optimal puncture site. Pleural effusion on the left side allows cardiac imaging from the back ( Fig. 24.14 ). Figure 24.5. [thoracickey.com]
Analysis of the fluid via pericardiocentesis is different than analyzing fluid from a pleural effusion or ascites. [healio.com]
Cardiac CT and MRI will also aid in differentiating an effusion from pericardial fat, pericardial cysts and pleural effusions, all of which can mimic a pericardial effusion. [clevelandclinicmeded.com]
This diagnosis should be considered in patients older than age 50 who have pericarditis or idiopathic pericardial or pleural effusions. [americannursetoday.com]
Treatment
Treatment depends on the cause. [tabletwise.com]
What should I expect for treatment? Christine Jellis, MD, PhD: Certainly there is a known link between pericarditis and lupus, so we would encourage your daughter to be further evaluated. Treatment will depend on her clinical features. [my.clevelandclinic.org]
Patient was diagnosed as having mixed connective tissue disorder (MCTD) and she was started on high dose prednisolone, which led to complete reversal of pancytopenia and pericardial tamponade after 1 month of treatment. [pagepress.org]
Clinical trials often give patients access to leading-edge treatments that are not yet widely available. [utswmed.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 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]
Prognosis is strongly linked to the underlying cause but long-term survival is more likely with surgery and the best results are achieved if surgery is offered early. [patient.info]
Outlook (Prognosis) Pericarditis can range from mild illness that gets better on its own, to a life-threatening condition. Fluid buildup around the heart and poor heart function can complicate the disorder. [health.firstlighthealthsystem.org]
PMR prognosis With prompt diagnosis and proper therapy, patients have an excellent prognosis. [americannursetoday.com]
Etiology
Etiology Hemopericardium Cardiac wall rupture (e.g., complication of myocardial infarction ) Chest trauma Aortic dissection Cardiac surgery (e.g., heart valve surgery, coronary bypass surgery ) Serous pericardial effusion Idiopathic Acute pericardi tis [amboss.com]
Etiology The most common form of acute pericarditis is idiopathic, which accounts for about 90% of cases ( Box 1 ). [clevelandclinicmeded.com]
Etiology Pericardial effusions can be caused by multiple disease states, including any process that results in pericarditis or myocarditis. The inflammatory reaction in these disease states can result in fluid accumulation in the pericardial space. [healio.com]
Etiology of pericardial cyst6 1.Congenital 2.Inflammatory: Rheumatic pericarditis, Bacterial infection particularly tuberculosis, Echinococcosis 3.Traumatic 4.Post cardiac surgery Table 2 : Etiology of pericardial cyst6. [interventional-cardiology.imedpub.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
Epidemiology, aetiology and classification of pericardial diseases 2.1 Epidemiology 2.2 Aetiology 3. [escardio.org]
Pathophysiology
Cardiology and Cardiovascular Medicine Cite this Apa Standard Harvard Vancouver BIBTEX RIS @article{764b48bd8e5b4033b423f165ff68ecd0, title = "Pericardial Effusion and Compressive Disorders of the Heart: Influence of New Technology on Unraveling its Pathophysiology [mayoclinic.pure.elsevier.com]
[…] surgery, coronary bypass surgery ) Serous pericardial effusion Idiopathic Acute pericardi tis (especially viral, but also fungal, tuberculous or bacterial) Malignancy Poststernotomy syndrome Uremic Autoimmune disorders Hypothyroidism References: [1] Pathophysiology [amboss.com]
Pathophysiology of cardiac tamponade. Chest. 1998;113:1372–8. CrossRef PubMed Google Scholar 7. Fowler NO. Cardiac tamponade. A clinical or an echocardiographic diagnosis? Circulation. 1993;87:1738–41. PubMed Google Scholar 8. Spodick DH. [link.springer.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]
Despite the significant difference in the pathophysiologic mechanisms of restriction and constriction, there is significant overlap in hemodynamic parameters between these two entities. [doctorlib.info]
Prevention
Cardiac tamponade occurs when a large pericardial effusion prevents the heart from properly filling with blood and therefore prevents the heart from pumping enough blood to the rest of the body. [msdmanuals.com]
[…] of Pericardial Disorders Yes, it may be possible to prevent Pericardial Disorders. [tabletwise.com]
Drug therapy Medications to reduce inflammation and prevent blood clotting, like aspirin and ibuprofen are administered in this process. [medanta.org]
Sometimes, more intense treatment is needed to prevent complications. Recovery from pericarditis may take a few days to weeks or even months. [heart.org]
The scarring constricts the movement of the heart during each heartbeat and can prevent the heart from expanding to accept blood returning from the body after each heartbeat. [medicinenet.com]