Cardiology

Acute Pericarditis ,causes, signs and symptoms, diagnosis and treatment

  • Clinicals
  • Cardiology
  • 2020-09-12 09:37:00
  • 2 minutes, 14 seconds

Acute Pericarditis ,causes, signs and symptoms, diagnosis and treatment

Pericarditis is an inflammatory process of the pericardium. Acute pericarditis, defined as signs and symptoms resulting from a pericardial inflammation of fewer than 2 weeks’ duration, may be infectious in origin or occur as the result of systemic disease.

Causes of Pericarditis

Viral infections (coxsackieviruses and echoviruses) are the most common cause of pericarditis.

Other causes of acute pericarditis include bacterial or mycobacterial infections, connective tissue diseases (e.g., systemic lupus erythematosus, rheumatoid arthritis), uremia, postcardiac surgery, neoplastic invasion of the pericardium, radiation, trauma, drug toxicity, and contiguous inflammatory processes of the myocardium or lung.

As an inflammatory condition, acute pericarditis often is associated with increased capillary permeability. The capillaries that supply the serous pericardium become permeable, allowing plasma proteins, including fibrinogen, to leave the capillaries and enter the pericardial space. This results in an exudate that varies in type and amount according to the causative agent.

Acute pericarditis frequently is associated with a fibrinous exudate and heals by resolution or progresses to deposition of scar tissue and formation of adhesions between the layers of the serous pericardium.

Signs and symptoms

The manifestations of acute pericarditis include a triad of:

The clinical findings may vary according to the causative agent.
Nearly all persons with acute pericarditis have chest pain. The pain usually is sharp and abrupt in onset, occurring in the precordial area, and may radiate to the neck, back, abdomen, or side.

Pain in the scapular area may be due to irritation of the phrenic nerve. The pain
typically is worse with deep breathing, coughing, swallowing, and postural changes because of changes in venous return and cardiac filling.

It is important that chest pain from pericarditis (which can be relieved by sitting and leaning forward) be differentiated from that of acute myocardial infarction or pulmonary embolism.

A pericardial friction rub results from the rubbing and friction between the inflamed pericardial surfaces.
 

Diagnosis

Diagnosis of acute pericarditis is based on clinical manifestations,

Treatment of acute pericarditis

Treatment depends on the cause.

When an infection is present, antibiotics specific for the causative agent usually are prescribed.

Aspirin and other (NSAIDs) may be given to minimize the inflammatory response and the accompanying undesirable effects.

A minority of patients who develop recurrent infection develop recurrent bouts of pericardial pain, which can sometimes be chronic and debilitating.

The process commonly is associated with autoimmune disorders, such as lupus erythematosus, rheumatoid arthritis, scleroderma, and myxedema, but may also occur following viral pericarditis.

Treatment of recurrent infection includes the use of anti-inflammatory medications such as NSAIDs, corticosteroids, or colchicine.


References:
author

Daniel Ogera

Medical educator, passionate about simplifying difficult medical concepts for easier understanding and mastery by nursing and medical students.

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About this article:
  • Topic:Clinicals
  • Duration:2 minutes, 14 seconds
  • Subtopic:Cardiology

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