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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.
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 ...
[4] [5] Diagnosis is based on the presence of chest pain, a pericardial rub, specific electrocardiogram (ECG) changes, and fluid around the heart. [6] A heart attack may produce similar symptoms to pericarditis. [1] Treatment in most cases is with NSAIDs and possibly the anti-inflammatory medication colchicine. [6]
The Tygerberg score is a clinical decision tool that allows the clinician to decide whether pericarditis is due to tuberculosis or not. It uses five variables: Weight loss (1 point) Night sweats (1 point) Fever (2 points) Serum globulin >40 g/L (3 points) Blood leukocyte count <10 × 10 9 /l (3 points)
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]
The accepted management of unstable angina and acute coronary syndrome is therefore empirical treatment with aspirin, a second platelet inhibitor such as clopidogrel, prasugrel or ticagrelor, and heparin (usually a low-molecular weight heparin), with intravenous nitroglycerin and opioids if the pain persists.
The typical signs of post-pericardiotomy syndrome include fever, pleuritis (with possible pleural effusion), pericarditis (with possible pericardial effusion), occasional but rare pulmonary infiltrates, and fatigue. [1] [2] Cough, pleuritic or retrosternal chest pain, joint pain and decreased oxygen saturation can also be seen in some cases. [1]
Tuberculous pericarditis is an under-diagnosed condition. [3] Diagnosis often requires a range of diagnostic tools, including pericardiocentesis, biochemical tests, and imaging. [3] [4] Treatment of this disease is similar to treatment of pulmonary tuberculosis. [1] [4] Alternative treatment options to reduce cardiac complications are also ...
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