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Periocarditis: A) Acute Pericarditis

Pericarditis is inflammation of the pericardium that has two types: acute and chronic. Acute pericarditis can be dry or wet. Chronic pericarditis presents as chronic constrictive pericarditis. Pericarditis has many causes including infection, autoimmune diseases, drugs, cancer, and more. Wet pericarditis involves an accumulation of fluid in the pericardial space causing more severe dyspnea. Diagnosis involves ECG, echocardiogram, and chest x-ray. Treatment depends on the underlying cause but may include aspirin, steroids, or antibiotics.

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61 views

Periocarditis: A) Acute Pericarditis

Pericarditis is inflammation of the pericardium that has two types: acute and chronic. Acute pericarditis can be dry or wet. Chronic pericarditis presents as chronic constrictive pericarditis. Pericarditis has many causes including infection, autoimmune diseases, drugs, cancer, and more. Wet pericarditis involves an accumulation of fluid in the pericardial space causing more severe dyspnea. Diagnosis involves ECG, echocardiogram, and chest x-ray. Treatment depends on the underlying cause but may include aspirin, steroids, or antibiotics.

Uploaded by

ssuhass243
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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PERIOCARDITIS

Pericarditis can be described as the patient present with


inflammatory changes involving pericarditis
It has two types
A) Acute Pericarditis
This can present with dry or wet pericarditis

B) Chronic Pericarditis
It presents as chronic constructive pericarditis

Etiology
Different disorder can involve the pericardium and thus causes are
1) Idiopathic / Non Specific pericarditis
2) Rheumatic pericarditis – seen in patient of rheumatic fever
3) Infective pericarditis
A) Viral
B) Bacterial – TB, Pyrogenic Organism
4) Metabolic disorder – Renal Failure
5) Collagen Disease involving pericardium
6) Malignant disorder involving pericardium
7) Traumatic pericarditis
8) Endocrine disease – hypothyroidism
9) Drug Induce Pericarditis
10) Post Myocardial Infaction Syndrome – It occurs complications of AMI
and this is also called as Dreston’s Syndrome with pericardial
involvement.
11) Dry PeriCurditis :
 It also called as acute fibrinous pericarditis
 In these patient present with generalized manifestation like fever,
malaise chills pain in limb, pain in joints weakness, nausea,
vomiting
 Along with this patient present with certain specific symptoms.
 E.g pain in chest and this chest pain in acute fibrinous pericarditis
is described as sharp stabbing pain and this chest pain < on deep
cough, supine position and >in standing up position.
 Along with this patient also complaint of dyspnea.
 On examination of patient even obviously febrile may be toxic with
evidence of tachycardia.
 On auscultation over pericardium we can hear the characteristic
sing of dry pericarditis i.e. pressure of pericardial rub which is a
scratching superficial sound that can be easily heard.

Investigation :
1) Routine test should be done – HB, WBC count only show
morphonuclear leukocytosis.
2) ECG in acute pericarditis shows characteristic changes in form of
evelvation of ST Segment.

Rx of acute fibrinous pericariditis


 Pt with Rheumatic pericarditis should be given. Tab aspirin along
with Inj. Penicilin.
 In few patient corticosteroid may be used.
 If the cause is TB then patient will given a standard Antitubercular
drug which include , INH, Isoniazide, Rifampicin, Pyrazinamide
Ethambutol

12) Wet Pericarditis


 Also called as pericarditis with effusion or pericardial effusion.
 This can develop as initial preservation in form of dry pericarditis
with subsequent accumulation of fluid into pericardial space and this
pericardial effusion can be define as an abnormal accumulation of
flaccid into the pericardial cavity
 Cause of pericardial effusion are similar to the causes described
previously
 In India commonest cause is TB

Clinical Feature :
 Patient present with symptom which are similar to dry pericarditis
but pericardial effusion to dyspnea is more much marked .
 Dyspnoea in pericardial effusion is though to develop from
compression of lungs and bronchi by the accumulation of fluid in
pericardial space.
 Dyspnoea is relieved in seating position with bending forward. In this
position fluid gravitates forward and downwards causing less
pressure over the lungs and bronchi .

Sign of pericardial Effusion on Examination :


 In this peripheral pulse is abnormal and it is described as pulses
paradoreus in which there is diminution of pulse volume during
inspiration.
 Neck veins are full and they appear more fall during inspiration and
there is destroyed as Rasmaul’s sign.
 On percussion over the pericardium their will be an increased area of
dullness that means all shifting up. This area of dullness auscultation
over chest, the heart sound heard comparatively soft or described as
muffled heart sound.
Investigation :
1) Routine Test - HB
2) ESR increased in patient with TB
3) Chest X ray will shows enlargement of heart.
4) Eco cardiography should be confirm diagnosis of pericardial effusion
and also used to access severe pericardial effusion.
5) Patient of pericardial effusion are at the risk of developing a
complication which known as cardiac Temponadi.

Cardiac Temponadi.
 It is serious life threatening complication in pericardial effusion in
which patient present with operation of heart by the large
accumulation fluid in precardial space or due to rapid accumulation
of fluid into pericardial space or due to rapid accumulation of fluid
into pericardial space.
 The patient with by rapid downhill course with evidence of
tachycardia, hypotension and muffled heart sound.
 The patient of cardiac temponadi will give urgent Rx which is in form
of pericardial papillae in which fluid from pericardial space is
aspirated. These fluid can be send to laboratory for pathological
examination and there will be helpful in the further management of
patient.

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