Pericarditis

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Pericarditis is inflammation of the pericardium surrounding the heart.[1][2][3][4]

Signs and symptoms

Published case series provide estimated of the sensitivity of clinical findings:[5][6][7]

  • The pain is usually pleuritic (it hurts when one breathes in or coughs).[3]
  • The pain is worse with laying down and is better with leaning forward.[3]
  • The pain may radiate to one or both trapezius ridges. [3]
  • 85 percent of patients have a friction rub.[2]

Treatment

Nonsteroidal anti-inflammatory (NSAID) medications are effective in 85 to 90% of patients.[6]

Hospitalization should be considered if one of the following are present: fever >38°C, subacute onset, immunodepression, trauma, oral anticoagulant therapy, myopericarditis, severe pericardial effusion, cardiac tamponade.[6]

Prognosis

Pericarditis is unlikely to cause a dysrrhythmias in the absence of myocardial disease.[8]

Most cases resolve within 2 to 3 weeks.[7]

15 to 30 percent of patients with idiopathic pericarditis will have a recurrence.[2]

References

  1. National Library of Medicine. Pericarditis. Retrieved on 2007-10-21.
  2. 2.0 2.1 2.2 Lange RA, Hillis LD (2004). "Clinical practice. Acute pericarditis". N. Engl. J. Med. 351 (21): 2195–202. DOI:10.1056/NEJMcp041997. PMID 15548780. Research Blogging.
  3. 3.0 3.1 3.2 3.3 Spodick DH (2003). "Acute pericarditis: current concepts and practice". JAMA 289 (9): 1150–3. PMID 12622586[e]
  4. Troughton RW, Asher CR, Klein AL (2004). "Pericarditis". Lancet 363 (9410): 717–27. DOI:10.1016/S0140-6736(04)15648-1. PMID 15001332. Research Blogging.
  5. Zayas R, Anguita M, Torres F, et al (1995). "Incidence of specific etiology and role of methods for specific etiologic diagnosis of primary acute pericarditis". Am. J. Cardiol. 75 (5): 378–82. PMID 7856532[e]
  6. 6.0 6.1 6.2 Imazio M, Demichelis B, Parrini I, et al (2004). "Day-hospital treatment of acute pericarditis: a management program for outpatient therapy". J. Am. Coll. Cardiol. 43 (6): 1042–6. DOI:10.1016/j.jacc.2003.09.055. PMID 15028364. Research Blogging.
  7. 7.0 7.1 Permanyer-Miralda G, Sagristá-Sauleda J, Soler-Soler J (1985). "Primary acute pericardial disease: a prospective series of 231 consecutive patients". Am. J. Cardiol. 56 (10): 623–30. PMID 4050698[e]
  8. Spodick DH (1984). "Frequency of arrhythmias in acute pericarditis determined by Holter monitoring". Am. J. Cardiol. 53 (6): 842–5. PMID 6702635[e]