Pericarditis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

Pericarditis is a cardiac disorder where the pericardiac sac surrounding the heart and roots of the great vessels coming from the heart is inflamed.
Pericarditis is caused by:
A. Infections

1. Bacterial- streptococcus
2. Viral - cytomegalovirus, enterovirus, influenza virus, hepatitis B virus, adenovirus, and herpes simplex virus
3. Mycotic
4. Tuberculosis
   B. Non- infection:
5. Autoimmune diseases include:
   a. Rheumatic fever
   b. Rheumatoid arthritis
   c. Systemic lupus erythrematosis
   d. Drug induced
6. Neoplastic
7. Uremia
8. Myxedema
9. Trauma
10. Myocardial infarction
11. Myocarditis,
12. Dissecting aortic aneurysm,
13. Radiation
    Symptoms:
14. Chest pain of sudden onset in the anterior chest
15. Pain is sharp and becomes worse with inspiration due to pleural inflammation.
16. Pain is relieved with sitting up and leaning forward and become worse on lying down
17. Pericardial rub is a typical sign of acute pericarditis.
    This rub is best heard at the left sternal border as a squeaky or scratching sound using the diaphragm of the stethoscope.
    The pericardial rub is due to the friction generated by the two inflamed layers of the pericardium.
    Diagnosis is by:
    Classic feature of chest pain and dyspnea with pericarditis
    ECG can be diagnostic in acute pericarditis and evolves in 4 stages.
    Stage 1 accompanies the onset of acute pain
    Stage 2 occurs several days later with the return of the ST segment to baseline
    Stage 3 ECG changes are T waves become inverted in stage 3 but without Q-wave formation
    Stage 4 ECG changes are the ECG returns to the prepericarditis baseline weeks to months after the initial onset
    The T-wave inversion may persist indefinitely in the chronic inflammation observed with tuberculosis, uremia, or neoplasm
    However, only 50% of patients with pericarditis experience all 4 stages.
    An important ECG finding is PR-segment depression, which has been reported in as many as 80% of viral pericarditis cases.
    MRI is sensitive for detecting pericardial effusion and loculated pericardial effusion and thickening.
    Pericardiocentesis is relatively safe when guided by echocardiography, especially with large free anterior effusion
    Treatments may include medicines and, less often, procedures or surgery.
    Medical treatment are:
    Antibiotics
    NSAIDs
    Surgical procedures for pericarditis include pericardiectomy, pericardiocentesis, pericardial window placement, and pericardiotomy.
    Pericardiectomy is the most effective surgical procedure for managing large effusions, because it has the lowest associated risk of recurrent effusions
    TABLE OF CONTENT
    Introduction
    Chapter 1 Pericarditis
    Chapter 2 Causes
    Chapter 3 Symptoms
    Chapter 4 Diagnosis
    Chapter 5 Treatment
    Chapter 6 Prognosis
    Chapter 7 Coronary Heart Disease
    Chapter 8 Cardiomyopathy
    Epilogue

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