Medical history (history of illness) is an important component in the diagnosis of pericarditis (inflammation of the heart sac). Family history Is there a history of frequent cardiovascular disease in your family? Social history Current medical history/systemic history (somatic and psychological complaints). Are you experiencing pain? If yes, when does the pain occur? Where is … Pericarditis: Medical History
Blood, blood-forming organs-immune system (D50-D90). Sarcoidosis – inflammatory systemic disease affecting primarily the skin, lungs, and lymph nodes. Endocrine, nutritional and metabolic diseases (E00-E90). Amyloidosis – extracellular (“outside the cell”) deposits of amyloids (degradation-resistant proteins) that can lead to cardiomyopathy (heart muscle disease), neuropathy (peripheral nervous system disease), and hepatomegaly (liver enlargement), among other conditions. … Pericarditis: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by pericarditis (inflammation of the heart sac): Cardiovascular system (I00-I99) Chronic pericarditis Chronic constrictive pericarditis – scarring remodeling (fibrosis and calcification) of the pericardium (<1%). Pericardial tamponade (pericardial tamponade) (wg exudative pericarditis, effusion amount greater than 400 ml; absolute emergency: there is … Pericarditis: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes [edema (water retention) to anasarca (accumulation of edema/tissue fluid in the connective tissue of the subcutis), thus generalized edema/water retention (i.e., on the complete body)] … Pericarditis: Examination
1st-order laboratory parameters-obligatory laboratory tests. Small blood count [leukocytes (white blood cells) ↑] Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate) [CRP ↑ or ESR ↑] Creatinine phosphokinase (CK), especially the isoenzyme MB (CK-MB), lactate dehydrogenase (LDH) – as specific markers of cardiac ischemia. Highly sensitive cardiac troponin T (hs-cTnT) or troponin … Pericarditis: Test and Diagnosis
Therapeutic Targets Improvement of the symptomatology Avoidance of complications Therapy recommendations Hospitalization: When a specific cause is highly probable (e.g., tuberculosis, systemic rheumatic diseases, and neoplasms). When markers of poor prognosis are present (e.g., subacute course, large pericardial effusion (pericardial effusion), pericardial tamponade, fever size >38°C, concomitant myocarditis (“accompanying myocarditis”), immunosuppression, trauma, and oral anticoagulation … Pericarditis: Drug Therapy
Obligatory medical device diagnostics. Electrocardiogram (ECG; recording of the electrical activities of the myocardium) – as basic diagnostic [acute stage: ST-segment elevations + PQ depression, positive T wave – see below for further details; with pronounced effusion or pericardial tamponade: low-voltage (decreased height of the QRS complex) and electrical alternans (changing size of the QRS … Pericarditis: Diagnostic Tests
The following symptoms and complaints may indicate pericarditis (inflammation of the heart sac): The clinical picture ranges from mild decreased performance to severe dyspnea (shortness of breath) as a sign of heart failure (cardiac insufficiency). Acute pericarditis Leading symptoms Pericarditic chest pain/acute chest pain (chest pain), i.e., stabbing retrosternal (behind the sternum/chest bone) pain [pain … Pericarditis: Symptoms, Complaints, Signs
Pathogenesis (development of disease) In pericarditis, there is loosening of the tissue and possibly fibrin secretion (fibrin (Latin : fibra “fiber”; “glue” of blood clotting) and secretion. Acute pericarditis is idiopathic (with no identifiable or detectable cause) or viral in 80 to 90% of cases. Other causes include autoimmune disease (approximately 7%), neoplasia/neoplasms (approximately 5%), … Pericarditis: Causes
The long-term prognosis of acute pericarditis is favorable with sufficient medical therapy and physical rest. General Measures Review of permanent medication due topossible effect on existing disease. Non-athletes: Acute pericarditis: sports activities should be discontinued until clinical symptoms are no longer detectable and normalization of inflammatory parameters (eg, CRP), electrocardiogram (ECG; recording of electrical activity … Pericarditis: Therapy
