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Post-Infarction Pericarditis

Pericarditis Following Mi


Presentation

  • Presents 70 fully illustrated case presentations with teaching points that make information easy to understand and digest.[books.google.de]
  • Presents 49 fully illustrated case presentations with teaching points that make information easy to understand and digest.[books.google.de]
  • Presents a new chapter on recording and interpreting heart rhythms in patients with pacemakers. Includes new material on interpreting ECG findings associated with implantable cardioverter-defibrillators.[books.google.com]
  • Improve your interpretation of presenting symptoms with 39 new topics in the Differential Diagnosis section, and optimize patient care with 12 new tables in the Clinical Practice Guidelines section.[books.google.com]
  • Focus on the practical guidance you need with the aid of a new, more templated format in which basic science content has been integrated within clinical chapters, and all procedural content has been streamlined for online presentation and paired with[books.google.com]
Pain
  • […] postinfarction pericarditis acute pericarditis developing within one week after myocardial infarction, manifested as pericardial pain, dyspnea, and a pericardial rub. Medical dictionary. 2011.[medicine.academic.ru]
  • It should be suspected in any patient with pleuropericardial pain. A pericardial friction rub may or may not be present.[link.springer.com]
  • Often times the symptoms of pericardial disease such as fever, chest pain, and shortness of breath are non-specific, making an accurate diagnosis a challenging task.[books.google.de]
  • Of note, the patient states that after the surgery, he had resolution of his chest pain, but he has started experiencing chest pain again.[medbullets.com]
  • Acute pericarditis causes chest pain, which may be very difficult to discern from pain caused by acute myocardial infarction.[ecgwaves.com]
Physician
  • Widely considered the optimal electrocardiography reference for practicing physicians, and consistently rated as the best choice on the subject for board preparation, this is an ideal source for mastering the fundamental principles and clinical applications[books.google.com]
  • ECG’s for the Emergency Physician Hampton JR. The ECG In Practice, 6e ECG LIBRARY Electrocardiogram About Dr Ed Burns Dr Ed Burns. Emergency Physician in Pre-hospital and Retrieval Medicine in Sydney, Australia.[lifeinthefastlane.com]
  • Here I have magnified V1-V3 for better comparison: Now the new ST elevation in V1-V3 is obvious The Emergency physician started therapy for NSTEMI. The first troponin returned at 2.25 ng/mL.[hqmeded-ecg.blogspot.com]
  • The choice between needle pericardiocentesis and surgical drainage depends on institutional resources and physician experience, the etiology of the effusion, the need for diagnostic tissue samples, and the prognosis of the patient.[merckmanuals.com]
Sepsis
  • Inside, you’ll find totally updated coverage of vital topics, such as coagulation and apoptosis in certain critical care illnesses, such as acute lung injury and adult respiratory distress syndrome; sepsis and other serious infectious diseases; specific[books.google.com]
  • The disease should be considered in all patients presenting with high fever, dyspnoea, and tachycardia with intrathoracic or subphrenic infections, or sepsis with symptoms that suggest pericardial involvement.[textbookofcardiology.org]
Swelling
  • Pericarditis is inflammation and swelling of the covering of the heart (pericardium). It can occur in the days or weeks following a heart attack. Two types of pericarditis can occur after a heart attack.[medlineplus.gov]
  • Dressler syndrome; Post-MI pericarditis; Post-cardiac injury syndrome; Postcardiotomy pericarditis Pericarditis is inflammation and swelling of the covering of the heart (pericardium). It can occur in the days or weeks following a heart attack.[stlukes-stl.com]
Dyspnea
  • […] postinfarction pericarditis acute pericarditis developing within one week after myocardial infarction, manifested as pericardial pain, dyspnea, and a pericardial rub. Medical dictionary. 2011.[medicine.academic.ru]
  • If not-asymptomatic Fatigue Dyspnea Edema JVD Chest pain EKG finding in pericardial effusion Low QRS voltage Limb leads 5mm Chest leads 10mm May consider amyloidosis, pericardial dx, lung dx or thick chest wall **Also has electrical alternans Electrical[quizlet.com]
  • Prolonged elevation of pulmonary venous pressure results in dyspnea (particularly during exertion) and orthopnea. Fatigue may be severe.[merckmanuals.com]
Failure to Thrive
  • Fred Ferri’s popular "5 books in 1" format provides quick guidance on menorrhagia, Failure to Thrive (FTT), Cogan’s syndrome, and much more.[books.google.com]
Chest Pain
  • Often times the symptoms of pericardial disease such as fever, chest pain, and shortness of breath are non-specific, making an accurate diagnosis a challenging task.[books.google.de]
  • Oliva PB, Hammill SC: The clinical distinction between postinfarction pericarditis and other causes of postinfarction chest pain: ancillary observations regarding the effect of lytic therapy upon the frequency of postinfarction pericarditis, postinfarction[link.springer.com]
  • Of note, the patient states that after the surgery, he had resolution of his chest pain, but he has started experiencing chest pain again.[medbullets.com]
  • However, acute pericarditis is more likely if inspiration and supine position worsens the chest pain, and sitting upright and leaning forward alleviates the chest pain; the pain in STEMI is unaffected by position.[ecgwaves.com]
  • It is characterized by chest pain, fever, pericarditis with a friction rub, pleurisy, pleural effusion, joint pain, and elevated white blood cell count and sedimentation rate.[medical-dictionary.thefreedictionary.com]
Pericardial Friction Rub
  • A pericardial friction rub may or may not be present. Differentiation of pericarditis from recurrent angina may be difficult, but a careful history and evaluation of serial electrocardiograms can help distinguish the two entities.[link.springer.com]
  • Pericardial pain and pericardial friction rub define early postinfarction pericarditis and usually develop on day 2 or 3 after a transmural myocardial infarction.[ncbi.nlm.nih.gov]
  • 95% of cases sudden onset, anterior aspect sharp and pleuritic in nature **increase pain with inspiration or cough *** decreased pain with sitting up or leaning forward May have hx of viral infection Pericardial friction rub in acute pericarditis highly[quizlet.com]
  • Typical symptoms include: pleuritic chest pain fever general malaise Typical signs comprise: leukocytosis and raised inflammatory markers pericardial friction rub (murmurs by auscultation) It is common for pericardial effusion to develop but tamponade[radiopaedia.org]
  • Auscultation may reveal pericardial friction rub, and heart sounds may be faint.[textbookofcardiology.org]
Pericardial Friction Rub
  • A pericardial friction rub may or may not be present. Differentiation of pericarditis from recurrent angina may be difficult, but a careful history and evaluation of serial electrocardiograms can help distinguish the two entities.[link.springer.com]
  • Pericardial pain and pericardial friction rub define early postinfarction pericarditis and usually develop on day 2 or 3 after a transmural myocardial infarction.[ncbi.nlm.nih.gov]
  • 95% of cases sudden onset, anterior aspect sharp and pleuritic in nature **increase pain with inspiration or cough *** decreased pain with sitting up or leaning forward May have hx of viral infection Pericardial friction rub in acute pericarditis highly[quizlet.com]
  • Typical symptoms include: pleuritic chest pain fever general malaise Typical signs comprise: leukocytosis and raised inflammatory markers pericardial friction rub (murmurs by auscultation) It is common for pericardial effusion to develop but tamponade[radiopaedia.org]
  • Auscultation may reveal pericardial friction rub, and heart sounds may be faint.[textbookofcardiology.org]
Heart Disease
  • . : Morphologic aspects of pericardial heart disease: part II . Clin Cardiol 1992, 15 :291–298. PubMed CrossRef Google Scholar 13.[link.springer.com]
  • Clinical Topics: Cardiac Surgery, Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Pericardial Disease, Cardiac Surgery and CHD and Pediatrics, Congenital Heart Disease, CHD[acc.org]
  • Code Classification Diseases of the circulatory system ( I00–I99 ) Ischemic heart diseases ( I20-I25 ) Other acute ischemic heart diseases ( I24 ) Version 2019 Billable Code Information for Medical Professionals Diagnostic Related Groups The diagnosis[icdlist.com]
  • Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier Saunders; 2019:chap 83. Little WC, Oh JK. Pericardial diseases. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed.[medlineplus.gov]
  • Other NSAIDs though once used to treat Dressler syndrome, are less advocated and should be avoided in patients with ischemic heart disease.[en.wikipedia.org]
Heart Disease
  • . : Morphologic aspects of pericardial heart disease: part II . Clin Cardiol 1992, 15 :291–298. PubMed CrossRef Google Scholar 13.[link.springer.com]
  • Clinical Topics: Cardiac Surgery, Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Pericardial Disease, Cardiac Surgery and CHD and Pediatrics, Congenital Heart Disease, CHD[acc.org]
  • Code Classification Diseases of the circulatory system ( I00–I99 ) Ischemic heart diseases ( I20-I25 ) Other acute ischemic heart diseases ( I24 ) Version 2019 Billable Code Information for Medical Professionals Diagnostic Related Groups The diagnosis[icdlist.com]
  • Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier Saunders; 2019:chap 83. Little WC, Oh JK. Pericardial diseases. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed.[medlineplus.gov]
  • Other NSAIDs though once used to treat Dressler syndrome, are less advocated and should be avoided in patients with ischemic heart disease.[en.wikipedia.org]
Suggestibility
  • Access full-color images and 65 online-only topics at Expert Consult, as well as online-only contents including EBMs, Suggested Reading, Patient Teaching Guides, and additional algorithms.[books.google.com]
  • A ratio of 0.25 suggests pericarditis A ratio of 0.25 suggests BER Example 1 Benign Early Repolarisation ST segment height 1 mm T wave height 6 mm ST / T wave ratio 0.16 The ST / T wave ratio 0.25 is consistent with BER.[lifeinthefastlane.com]
  • However, the frequency of patients with ECG signs suggestive of pericarditis (60%) was significantly higher in the inflammation group compared with the effusion group (34%), and the normal group (17%).[imaging.onlinejacc.org]
  • Returning to our patient: Although acute myocardial infarction (A) is possible her acute change in presentation and previously history are suggestive of something more.[mededmasters.com]
  • Cardiac catheterization, right and left sided, is done if clinical and echocardiographic findings suggest constrictive pericarditis.[merckmanuals.com]

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]
ST Elevation
  • 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]
  • This can lead to ST elevation in all leads. Therefore, it is important to distinguish pericarditis from a myocardial infarction, which has more acute complaints and ST-elevations are limited to the infarct area.[en.ecgpedia.org]
  • The most important change, though, is the ST elevation in inferior leads and the reciprocal depression in aVL.[hqmeded-ecg.blogspot.com]
  • It occurs most commonly with anterior MI’s and MI’s with massive ST elevation.[almostadoctor.co.uk]
ST Elevation
  • 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]
  • This can lead to ST elevation in all leads. Therefore, it is important to distinguish pericarditis from a myocardial infarction, which has more acute complaints and ST-elevations are limited to the infarct area.[en.ecgpedia.org]
  • The most important change, though, is the ST elevation in inferior leads and the reciprocal depression in aVL.[hqmeded-ecg.blogspot.com]
  • It occurs most commonly with anterior MI’s and MI’s with massive ST elevation.[almostadoctor.co.uk]
T Wave Inversion
  • Ancillary observations regarding the effect of reperfusion on the rapidity and amplitude of T wave inversion after acute myocardial infarction . Circulation 1993, 88 :896–904. PubMed Google Scholar 7.[link.springer.com]
  • T-wave inversions (negative T-waves) ST elevations are normalized slowly in pericarditis. It may take weeks for the ST elevations to resolve. Thereafter, T-wave inversion typically ensues.[ecgwaves.com]
  • […] scratchy or squeaky quality LSB Absence does NOT exclude diagnosis Common symptoms in acute pericarditis pain radiation to TRAPEZIUS RIDGE EKG findings in acute pericarditis ST segment elevation-diffuse T wave inversion after ST segments RTB PR segment[quizlet.com]
  • There may also be PR interval depression – and if both of these are present it is pretty much diagnostic for pericarditis Later there may also be T wave inversion – especially if myocarditis is also present.[almostadoctor.co.uk]
  • Stage III: T waves are inverted throughout the ECG; T waveinversion occurs after the ST segment has returned to baseline and thus differs from the pattern of acute ischemia or MI. Stage IV: T wave changes resolve.[merckmanuals.com]
Abnormal ECG
  • Comprehensively and expertly describes how to capture and interpret all normal and abnormal ECG findings in adults and children.[books.google.com]

Treatment

  • Detailed discussions of hot topics, full-color illustrations, and a DVD of procedural video clips, animations, and downloadable image libraries help you provide fast, appropriate treatment for each challenging case you face.[books.google.de]
  • This paper reviews diagnosis, complications, and treatment post-myocardial infarction and postcardiotomy pericarditis. PubMed Google Scholar 12. Waller BF, Taliercio CP, Howard J, et al. : Morphologic aspects of pericardial heart disease: part II .[link.springer.com]
  • The goal of treatment is to make the heart work better and reduce pain and other symptoms.[stlukes-stl.com]
  • The prognosis for timely initiation of treatment generally favourable. Without treatment, the possible outcome in adhesive pericarditis. Post-infarction syndrome is not always detected correctly.[medicalency.com]

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 for timely initiation of treatment generally favourable. Without treatment, the possible outcome in adhesive pericarditis. Post-infarction syndrome is not always detected correctly.[medicalency.com]
  • Prognosis of the disease is excellent, as severe complications are rare.[textbookofcardiology.org]
  • Supraventricular tachycardias, although less common (less than 10% of post-MI patients) portend a poorer prognosis (in contradistinction to SVT in a non-ischemic setting). Bradydysrythmias in turn carry a poor prognosis after MI.[mededmasters.com]

Etiology

  • […] efficiency-limits dilation protect from infection and malignancy autonomically fixes heart Most common disorder involving pericardium Acute pericarditis: 5% of pts presenting in ER with non-ischemic chest pain pathophys: inflammation of pericardial tissue Etiology[quizlet.com]
  • Fulminant clinical tamponade presents with symptoms that depend on its etiology.[textbookofcardiology.org]
  • Needle pericardiocentesis is often best when the etiology is known or the presence of tamponade is in question. Surgical drainage is best when the presence of tamponade is certain but the etiology is unclear.[merckmanuals.com]
  • The etiology is not well understood, and several possible pathomechanisms have been proposed, including local inflammation, autoimmune response and latent viruses.[radiopaedia.org]
  • In a recent study, Merce et al found no difference in etiology, clinical course, and prognosis between elderly and younger patients with moderate and large pericardial effusions.[healthguidance.org]

Epidemiology

  • Epidemiology, aetiology and classification of pericardial diseases 2.1 Epidemiology 2.2 Aetiology 3.[escardio.org]
  • Epidemiology Accounts for 5% of Emergency Department Chest Pain cases Most typical patient is a male aged 20 to 50 years old However occurs in both genders and at all ages III.[fpnotebook.com]
Sex distribution
Age distribution

Pathophysiology

  • This paper reviews the pathophysiology and difficulties in diagnosis of post-myocardial infarction pericarditis and discusses long-term outcome. PubMed Google Scholar 6.[link.springer.com]
  • Thus, incomplete recanalization of infarct-related coronary artery appears to be a pathophysiological link to hemorrhagic PE and threatening rupture.[circ.ahajournals.org]
  • 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

  • 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]
  • ., tuberculous pericarditis) is recommended to prevent the progression of constriction. Multimodality imaging.[acc.org]
  • These professionals can also communicate with your primary care doctor or cardiologist. [10] Prevention - Dietary Modification There are alternative/holistic options that can be employed to prevent an MI or additional MIs, which focus around diet and[physio-pedia.com]
  • Epidemiology 5.2.2.2 Diagnosis 5.2.2.3 Management 5.3 Pericarditis in renal failure 5.4 Pericardial involvement in systemic autoimmune and autoinflammatory diseases 5.5 Post-cardiac injury syndromes 5.5.1 Definition and diagnosis 5.5.2 Management 5.5.3 Prevention[escardio.org]
  • The only time heparin could be used with pericarditis is with coexisting acute MI in order to prevent further thrombus formation. [9] References [ edit ] Hutchcroft, B J (1 July 1972). "Dressler's syndrome".[en.wikipedia.org]

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