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Treatment for purulent pericarditis consists of two main components. [3] Antimicrobial therapy. Empiric intravenous antimicrobial therapy is recommended as soon as a diagnosis of purulent pericarditis is suspected. [3] Pericardial drainage. There are several therapeutic mechanisms that can be used to drain purulent fluid from the pericardial sac.
It should be considered in all patients with acute pericarditis, preferably in combination with a short-course of NSAIDs. [10] For patients with a first episode of acute idiopathic or viral pericarditis, they should be treated with an NSAID plus colchicine 1–2 mg on first day followed by 0.5 daily or twice daily for three months.
In this case, the patient is experiencing post-myocardial infarction pericarditis (PIP), which is characterized by chest pain, low-grade fever, and specific findings on physical examination and electrocardiogram. Aspirin is the drug of choice for PIP and is usually already prescribed for secondary prevention following a myocardial infarction.
Constrictive pericarditis is a condition characterized by a thickened, fibrotic pericardium, limiting the heart's ability to function normally. [1] In many cases, the condition continues to be difficult to diagnose and therefore benefits from a good understanding of the underlying cause.
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 ...
During medical doctor examination, a pericardial friction rub can be auscultated indicating pericarditis. Auscultation of the lungs can show crackles indicating pulmonary infiltration, and there can be retrosternal/pleuritic chest pain worse on inspiration (breathing in). Patient can also depict sweating (diaphoresis) and agitation or anxiety.
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]
Important etiologies of pericardial effusions are inflammatory and infectious (pericarditis), neoplastic, traumatic, and metabolic causes. Echocardiogram, CT and MRI are the most common methods of diagnosis, although chest X-ray and EKG are also often performed. Pericardiocentesis may be diagnostic as well as therapeutic (form of treatment).
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