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Purulent Pericarditis; Echocardiogram showing pericardial effusion with signs of cardiac tamponade: Specialty: Cardiology: Symptoms: substernal chest pain (exacerbated supine and with breathing deeply), dyspnea, fever, rigors/chills, and cardiorespiratory signs (i.e., tachycardia, friction rub, pulsus paradoxus, pericardial effusion, cardiac tamponade, pleural effusion)
The disease consists of persistent low-grade fever, chest pain (usually pleuritic), pericarditis (usually evidenced by a pericardial friction rub, chest pain worsening when recumbent, and diffuse ST elevation with PR segment depression), and/or pericardial effusion. The symptoms tend to occur 2–3 weeks after myocardial infarction but can also ...
The pericardial rub is said to be generated from the friction generated by the two inflamed layers of the pericardium; however, even a large pericardial effusion does not necessarily present a rub. The rub is best heard during the maximal movement of the heart within the pericardial sac, namely, during atrial systole , ventricular systole, and ...
Out of all the numerous causes of pericardial effusion, some of the leading causes are inflammatory, infectious, neoplastic and traumatic. These causes can be categorized into various classes, but an easy way to understand them is dividing them into inflammatory versus non-inflammatory. [citation needed] A pericardial effusion due to pericarditis
The diagnosis of tamponade can be confirmed with trans-thoracic echocardiography (TTE), which should show a large pericardial effusion and diastolic collapse of the right ventricle and right atrium. Chest X-ray usually shows an enlarged cardiac silhouette ("water bottle" appearance) and clear lungs. Pulmonary congestion is typically not seen ...
The definitive treatment for constrictive pericarditis is pericardial stripping, which is a surgical procedure where the entire pericardium is peeled away from the heart. This procedure has significant risk involved, [ 14 ] with mortality rates of 6% or higher in major referral centers.
The differential diagnoses of Kussmaul's sign includes constrictive pericarditis, restrictive cardiomyopathy, pericardial effusion, and severe right-sided heart failure. [ citation needed ] With cardiac tamponade , jugular veins are distended and typically show a prominent x descent and an absent y descent as opposed to patients with ...
Uremic pericarditis is associated with azotemia, and occurs in about 6-10% of kidney failure patients. BUN is normally >60 mg/dL (normal is 7–20 mg/dL). However, the degree of pericarditis does not correlate with the degree of serum BUN or creatinine elevation. The pathogenesis is poorly understood. [2]