Pericardial Disease

Posted by e-Medical PPT
Pericarditis is an inflammation of the pericardium.Depending on the time of presentation and duration, it  is divided into "acute" and "chronic" forms. Acute pericarditis is more common than chronic pericarditis, and can occur as a complication of infections, immunologic conditions, or even as a result of a myocardial infarction.Chronic type however is less common, a form of which is constrictive pericarditis.
It may be caused by viral, bacterial, or fungal infection.The most common worldwide cause  is infectious pericarditis with Tuberculosis.Other causes are systemic lupus erythematosus (more common among women) or rheumatic fever,Myocardial Infarction (Dressler's syndrome),Trauma to the heart, e.g. puncture, resulting in infection or inflammation,Uremia ect
Substernal or left precordial pleuritic Chest pain with radiation to the bottom portion of scapula on the back, which is relieved by sitting up and bending forward and worsened by lying down or inspiration,is the characteristic pain of pericarditis.Other symptoms  may include dry cough, fever, fatigue, and anxiety.
Pericarditis can progress to pericardial effusion and eventually cardiac tamponade. This can be seen in patients who present experiecing the classic signs of pericarditis but who will then obtundate, and progress to show signs of tamponade which include decresaed alertness and lethargy, pulsus paradoxus (decrease of at least 10 mmHg of the systolic blood pressure upon inspiration), hypotension (due to decreased cardiac index), elevated JVP, distant heart sounds on auscultation, and equilibration of all the diastolic blood pressures on cardiac catheretization due to the constriction of the pericardium by the fluid.

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