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Pericarditis is inflammation of the sac surrounding the heart, the pericardium. Acute pericarditis is the most common form of pericarditis.
Pathology
Fibrinous pericarditis is an exudative inflammation. The pericardium is infiltrated by the fibrinous exudate. This consists in fibrin strands and leukocytes. Fibrin describes an eosinophilic (pink) network, amorphous. Leukocytes (mainly, neutrophils) are found within the fibrin deposits and intrapericardic. Vascular congestion is also present. The myocardium has no changes. Photo at: Atlas of Pathology
Signs and Symptoms
Chest pain, radiating to the back and relieved by sitting up forward, is the classical presentation. Other symptoms of pericarditis may include dry cough, fever, fatigue and anxiety.
The classic sign of pericarditis is a pericardial rub. Other signs include ST-elevation on EKG (all leads) and the signs of cardiac tamponade (pulsus paradoxus, hypotension) and congestive heart failure (elevated jugular venous pressure, peripheral edema).
Causes
- Coxsackie viral infection
- Rheumatismal
- Tuberculosis
- Uremia
- Malignancy (paraneoplastic phenomenon)
- Lupus erythematosus
- Idiopathic
- Side effect of some medications, isoniazid, cyclosporine
- Trauma to the heart
Complications
Complications may include:
Treatment
The treatment in viral or idiopathic pericarditis is with non-steroidal anti-inflammatory drugs. Severe cases may require:
External links
- Pericarditis - Mayo Clinic series
- Pericarditis - cardiologychannel.com
- Pericarditis information from Seattle Children's Hospital Heart Center
- Pulsus paradoxus - Journal of Postgraduate Medicine
"Pericarditis"