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Pericarditis
| Pericarditis | |
|---|---|
 | |
| An ECG showing pericarditis, with ST elevation in multiple leads and slight reciprocal ST depression in aVR. | |
| Specialty | Cardiology |
| Symptoms | Sharp chest pain, better sitting up and worse with lying down, fever[1] |
| Complications | Cardiac tamponade, myocarditis, constrictive pericarditis[1][2] |
| Usual onset | Typically sudden[1] |
| Duration | Few days to weeks[3] |
| Causes | Viral infection, tuberculosis, uremic pericarditis, following a heart attack, cancer, autoimmune disorders, chest trauma[4][5] |
| Diagnostic method | Based on symptoms, electrocardiogram, fluid around the heart[6] |
| Differential diagnosis | Heart attack[1] |
| Treatment | NSAIDs, colchicine, corticosteroids[6] |
| Prognosis | Usually good[6][7] |
| Frequency | 3 per 10,000 per year[2] |
Pericarditis is inflammation of the pericardium, the fibrous sac surrounding the heart.[8] Symptoms typically include sudden onset of sharp chest pain, which may also be felt in the shoulders, neck, or back.[1] The pain is typically less severe when sitting up and more severe when lying down or breathing deeply.[1] Other symptoms of pericarditis can include fever, weakness, palpitations, and shortness of breath.[1] The onset of symptoms can occasionally be gradual rather than sudden.[8]
The cause of pericarditis often remains unknown but is believed to be most often due to a viral infection.[4][8] Other causes include bacterial infections such as tuberculosis, uremic pericarditis, heart attack, cancer, autoimmune disorders, and chest trauma.[4][5] Diagnosis is based on the presence of chest pain, a pericardial rub, specific electrocardiogram (ECG) changes, and fluid around the heart.[6] A heart attack may produce similar symptoms to pericarditis.[1]
Treatment in most cases is with NSAIDs and possibly the anti-inflammatory medication colchicine.[6] Steroids may be used if these are not appropriate.[6] Symptoms usually improve in a few days to weeks but can occasionally last months.[3] Complications can include cardiac tamponade, myocarditis, and constrictive pericarditis.[1][2] Pericarditis is an uncommon cause of chest pain.[9] About 3 per 10,000 people are affected per year.[2] Those most commonly affected are males between the ages of 20 and 50.[10] Up to 30% of those affected have more than one episode.[10]
- ^ a b c d e f g h i "What Are the Signs and Symptoms of Pericarditis?". National Heart, Lung, and Blood Institute. September 26, 2012. Archived from the original on 2 October 2016. Retrieved 28 September 2016.
- ^ a b c d Imazio M, Gaita F (July 2015). "Diagnosis and treatment of pericarditis". Heart. 101 (14): 1159–68. doi:10.1136/heartjnl-2014-306362. PMID 25855795. S2CID 35310104.
- ^ a b "How Is Pericarditis Treated?". National Heart, Lung, and Blood Institute. September 26, 2012. Archived from the original on 2 October 2016. Retrieved 28 September 2016.
- ^ a b c Tingle LE, Molina D, Calvert CW (November 2007). "Acute pericarditis". American Family Physician. 76 (10): 1509–14. PMID 18052017.
- ^ a b "What Causes Pericarditis?". National Heart, Lung, and Blood Institute. September 26, 2012. Archived from the original on 2 October 2016. Retrieved 28 September 2016.
- ^ a b c d e f Imazio M, Gaita F, LeWinter M (October 2015). "Evaluation and Treatment of Pericarditis: A Systematic Review". JAMA. 314 (14): 1498–506. doi:10.1001/jama.2015.12763. hdl:2318/1576078. PMID 26461998.
- ^ Cunha BA (2010). Antibiotic Essentials. Jones & Bartlett Publishers. p. 71. ISBN 978-1-4496-1870-4.
- ^ a b c "What Is Pericarditis?". National Heart, Lung, and Blood Institute. September 26, 2012. Archived from the original on October 2, 2016.
- ^ McConaghy JR, Oza RS (February 2013). "Outpatient diagnosis of acute chest pain in adults". American Family Physician. 87 (3): 177–82. PMID 23418761.
- ^ a b "Who Is at Risk for Pericarditis?". National Heart, Lung, and Blood Institute. September 26, 2012. Archived from the original on 2 October 2016. Retrieved 28 September 2016.
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