Pericarditis

Introduction Pericarditis refers to acute inflammatory reactions and exudates due to factors such as bacteria, viruses, autoimmunity, physics, and chemistry, as well as chronic lesions such as pericardial adhesion, thickening, narrowing, and calcification. Clinically, there are mainly acute pericarditis and chronic constrictive pericarditis. The patient has symptoms such as fever, night sweats, cough, sore throat or vomiting, and diarrhea. Acute pericardial tamponade can occur with a large amount of effusion in the pericardium. The patient had chest pain, difficulty breathing, cyanosis, pale complexion, and even shock. There may also be symptoms such as ascites and liver.

Cause

Pericarditis can be caused by a variety of virulence factors, often as part of a systemic disorder, or by the spread of inflammation in adjacent tissues. There are eight common causes of pericarditis:

Infection

The pathogens include bacteria (including Mycobacterium tuberculosis), viruses, fungi, parasites, rickettsia, and the like.

2. Tumor

Primary and secondary tumors.

3. Autoimmune

Rheumatic fever and other collagen tissue diseases such as systemic lupus erythematosus, nodular polyarteritis, rheumatoid arthritis. After a heart injury, such as the pericardial incision syndrome.

4. Endocrine and metabolic disorders

Uremic, mucinous edema, cholesterol pericarditis.

5. Physical factors

Trauma, radiotherapy.

6. Chemical factors

Anthraquinone, procainamide, and the like.

7. Adjacent organ diseases.

8. Unexplained acute non-specific pericarditis.

an examination

Related inspection

Dynamic electrocardiogram (Holter monitoring) Cardiac vascular ultrasound M-mode echocardiography (ME)

X-ray inspection

When the amount of fluid exceeds 300 ml, the heart shadow increases to both sides, and the angle of the heart becomes an acute angle. At more than 1000 ml, the heart shadow is in the form of a flask and varies with body position. The heart beats weakened or disappeared.

2. ECG

In the case of dry pericarditis, each lead (except aVR), the ST segment is raised, and returns to the equipotential line after a few days, and the T wave is flat or inverted. The QRS complex is low voltage when the pericardium has exudate.

3. Echocardiography

It shows that there is a liquefied dark area in the pericardial cavity, which is an accurate, safe and simple diagnostic method.

Differential diagnosis

Inflammation of the pericardium: The pericardium is a fibrous membrane that surrounds the heart. The lumen of the membrane is a smooth, smooth serosa that continues with the epicardium. That is, the pericardium, but some refer only to the wall layer of the pericardium. It consists of two layers, inner and outer. Supports the heart, protects and prevents the heart from over-expanding.

Pericardial fiber thickening: refers to inflammation caused by pericardial fibrosis, adhesion, endocardial thickening.

Pericardial rupture: Pericardial rupture is more common in penetrating cardiac trauma. Penetrating heart trauma is caused by a strong, high-speed, sharp foreign body that penetrates the chest wall or enters the heart. A small number of fractures due to sternal or rib fractures A violent shift caused by puncture of the heart. Heart penetrating injuries have pericardial breaks, and sometimes there are many heart wounds, which are especially common in stab wounds and gunshot wounds.

Patients may have fever, night sweats, cough, sore throat, or vomiting or diarrhea. Acute heart tamponade can occur when the pericardium quickly exudes a large amount of fluid. The patient has chest pain, difficulty breathing, cyanosis, pale complexion, and even shock. There may also be ascites, hepatomegaly and other symptoms.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.