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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)
A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous connective membrane and an inner two-layered serous membrane .
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 ...
Rarely, electrical alternans may be seen, depending on the size of the effusion. [citation needed] A chest x-ray is usually normal in acute pericarditis but can reveal the presence of an enlarged heart if a pericardial effusion is present and is greater than 200 mL in volume. Conversely, patients with unexplained new onset cardiomegaly should ...
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 ...
On a chest X-ray, the normal heart silhouette should have a clear and defined outline. However, in cases of pericardial effusion, the accumulation of fluid within the pericardial sac causes the heart to appear enlarged and assumes a shape that is reminiscent of a water bottle, with relatively smooth cardiac contours. [2]
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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