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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)
Complications can include cardiac tamponade, myocarditis, and constrictive pericarditis. [1] [2] Pericarditis is an uncommon cause of chest pain. [9] About 3 per 10,000 people are affected per year. [2] Those most commonly affected are males between the ages of 20 and 50. [10] Up to 30% of those affected have more than one episode. [10]
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.
Pericardial effusion – The serous pericardium normally contains fluid that reduces friction, but an abnormal accumulation of fluid in the pericardium is called a pericardial effusion. The list of causes is lengthy but includes pericarditis, rheumatic diseases (e.g., systemic lupus erythematosus), trauma, and blood from myocardial rupture.
[2] 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.
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 pericardium, the double-walled sac surrounding the heart, consists of a fibrous pericardium layer on the outside and a double-layered serous pericardium on the inside. [18] Between the two layers of the serous pericardium is the pericardial space, which is filled with lubricating serous fluid that prevents friction as the heart contracts. [19]
It consists of fever, pleuritic pain, pericarditis and/or pericardial effusion. Dressler syndrome is also known as postmyocardial infarction syndrome [1] and the term is sometimes used to refer to post-pericardiotomy pericarditis. It was first characterized by William Dressler at Maimonides Medical Center in 1956. [2] [3] [4]
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