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The onset of purulent pericarditis is usually acute, with most individuals presenting to a medical facility approximately 3 days following the onset of symptoms. [4] As a subtype of pericarditis, purulent pericarditis often presents with substernal chest pain that is exacerbated by deep breathing and lying in the supine position. [5]
For acute pericarditis to formally be diagnosed, two or more of the following criteria must be present: chest pain consistent with a diagnosis of acute pericarditis (sharp chest pain worsened by breathing in or a cough), a pericardial friction rub, a pericardial effusion, and changes on electrocardiogram (ECG) consistent with acute pericarditis ...
Acute pericarditis is more common than chronic pericarditis, and can occur as a complication of infections, immunologic conditions, or even as a result of a heart attack (myocardial infarction), as Dressler's syndrome. Chronic pericarditis however is less common, a form of which is constrictive pericarditis.
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.
However, its use for treating constrictive pericarditis has a fairly high mortality rate, initially between 5% and 15%. [ 3 ] [ 4 ] The 5-year survival rate is around 80%. [ 3 ] The most common complication after surgery is reduced cardiac output , which occurs in between 14% and 28% of patients.
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).
Dressler syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of fever, pleuritic pain, pericarditis and/or pericardial effusion.
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]