PericardiaI Diseases Diagnosis Causes and Physical findings and PericardiaI Diseases Treatment

PericardiaI Diseases CausesToxic Hepatitis and Drug Induced Hepatitis Diagnosis and Treatment. Read more ... » and TreatmentToxic Hepatitis and Drug Induced Hepatitis Diagnosis and Treatment. Read more ... » –

• The heartAcute Myocardial Infarction Management REGIME FOR MANAGEMENT OF AMI. Read more ... » is covered by two protective membranes­
• Parietal pericardium - Fibrous outer mem­brane.
• Visceral pericardium - Serous inner mem­brane.
• The pericardium is a fibroelastic sac made up of visceral and parietal layers separated by a (potential) space, the pericardial cavity.

The functions of the pericardium are:

• It prevents sudden dilatation and stretching It fixes the heart, and prevents displacement Minimizes flexion
• Prevents spread of infection.

Diseases of the pericardium present clinically in one of four ways:

• AcuteToxic Hepatitis and Drug Induced Hepatitis Diagnosis and Treatment. Read more ... » fibrinous pericarditisCOMPLICATIONS OF Acute Myocardial Infarction (AMI) AND TREATMENT -2. Read more ... »
• Pericardial effusion without major hemodynamic compromise
• CardiacACTH and TSH DEFICIENCY Diagnosis with Treatment. Read more ... » tamponade
• Constrictive pericarditisCHRONIC CONSTRICTIVE PERICARDITIS Physical findings and Treatment. Read more ... »

PericardiaI Diseases DIAGNOSTIC and CLINICALToxic Hepatitis and Drug Induced Hepatitis Diagnosis and Treatment. Read more ... » PRESENTATION –

• ECGAcute Myocardial Infarction Management REGIME FOR MANAGEMENT OF AMI. Read more ... » changes — new widespread ST elevation or PR depression
• Pericardial effusion
• Chest painApproach to Chest Pain Differential diagnosis of chest pain. Read more ... »
• Pericardial friction rub

 

ACUTE PERICARDITIS

 

 

• Acute pericarditis is acute inflammationPterocarpus marsupium Indian Kino Bijaka ASANA (Heart wood) Ayurvedic Medicine OF inflammation diabetes. Read more ... » of the peri­cardium.
• Diagnosed by typical pericardial pain, pericardial fric­tion rub, ECG changes, pericardial effusion, cardiac tamponadeCARDIAC TAMPONADE Causes with Physical findings and Treatment. Read more ... » and paradoxical pulseCARDIAC TAMPONADE Causes with Physical findings and Treatment. Read more ... ».

 

Chest pain of pericarditis

 

 

• Moderate or severe Retrosternal and left precordial
• May be a constricting pain or heaviness May be referred to back
• May be aggravated by coughing and deep inspi­ration
• May radiate to one or both arms
• Relieved by sitting up and leaning forwards Increased in the supine position.

 

Pericardial Friction Rub

 

 

• May be heard in different parts of the cardiac cycle
• It is heard mostly during expiration
• It is high-pitched, grating or scratching
• Best heard in sitting position
• Pericardial rub may appear and disappear within a day.

 

Causes of pericarditis (PericardiaI Diseases)

Infections –

• Viral - coxsackie virus, mumpsMeasles Mumps Causative Virus Diagnosis Clinical Signs and Symptoms With Treatment. Read more ... », hepatitis, HIVAIDS Acquired Immunodeficiency Syndrome Diagnosis Signs and Symptoms with Treatment. Read more ... »
• Bacterial – Pneumococcus, streptococcus, sta­phylococcus,lubercular-
• Fun al - Histoplasma, candida

PericardiaI Diseases Other causes -

• syphilis, parasitic, protozoal
• Rheumatic feverRheumatic Fever Causes of Rheumatic fever Diagnosis Rheumatic fever TREATMENT. Read more ... »
• Collagen vascular diseaseToxic Hepatitis and Drug Induced Hepatitis Diagnosis and Treatment. Read more ... »
• DrugToxic Hepatitis and Drug Induced Hepatitis Diagnosis and Treatment. Read more ... » induced – Procainamide, hydralazine, phenytoin
• Post cardiac injury – after MI, trauma.
• MI
• Uraemia
• Tumors – Benign, malignant
• Myxoedema
• Trauma
• Aortic dissectionAORTIC DISSECTION Etiology and Clinical manifestations with Treatment. Read more ... »
• Acute idiopathic
• SarcoidosisSarcoidosis Causes Diagnosis Symptoms and Treatment. Read more ... »

 

ECG

 

 

• Elevation of ST se ments with concavity upwards in several leads.
• Low voltage ECG
• T inverted in several leads waves
• Q wave may be present.

 

PERICARDIAL EFFUSION

 

 

• Pericarditis may be associated with effusion in peri­cardial space called pericardial effusion.

PericardiaI Diseases Etiology: is same as pericarditis.

• In rheumatic fever there is no pericardial effusion.
• In uraemia, tuberculosis, malignancy, viral, bacterial causes there may be massive pericardial effusion.

PericardiaI Diseases Physical findings :

• Area of cardiac percussionHow to take good medical history & examination. Read more ... » is increased. Heart sounds are faint
• There may not be any friction rub NP is raised
• There may be ascites
• Apical cardiac impulse not palpable
• Ewart’s sign – dullness below left sca~la due t9 collapsed lung, may be prese’lt.

 

Chest X-ray

• Outline of heart is enlarged, and water bottle or flask-shaped or globular (rounded).

 

PericardiaI Diseases Echocardiography2D Echocardiography Dobutamine Stress Echocardiography. Read more ... »

 

 

• The best bedside tool for diagnosing pericardial effusion is echocardiography.
• Pericardial fluid can be seen as echo-free space between posterior pericardium and left ventricu­lar free wall or between anterior right ventricle and anterior chest wall.
• Pericardial thickening can be seen. Cardiac tamponade can also be identified.

 

CT I MRI

• CT and MRI can detect pericardial thickening and locu­lated effusion.

PericardiaI Diseases Treatment

• Treat the etiology
• IV fluids to increase cardiac output Pericardiocentesis – Pericardial fluid is aspirated under echocardiographic screening
• The fluid is sent for diagnosis
• Aspiration of fluid relieves the symptomsToxic Hepatitis and Drug Induced Hepatitis Diagnosis and Treatment. Read more ... » – thera­peutic aspiration
• Fluid is usually exudate
• Transudate is found in heart failureHeart Failure Treatment Heart Failure GENERAL PRINCIPLES. Read more ... »
• Bloody pericardial fluid is found in tuberculosis, uraemia, tumour, trauma.