MAGEZI

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PERICARDITIS

Posted by SAMUEL ISABIRYE on February 5, 2013 at 4:55 PM

Inflammation of the heart membrane (pericardium)

which may be:

z

Acute and self-limiting, sub-acute or chronic

z

Fibrinous, serous, haemorrhagic or purulent

 

 

UCG 2010

204

 

 

 

9. Cardiovascular diseases

Causes

 

z

Viral, eg. Coxsackie A & B, influenza A & B,

Varicella

 

z

Bacterial, eg. mycobacterium, staphylococcus,

meningococcus, streptococcus, pneumococcus,

gonococcus

 

z

Fungal: histoplasmosis

 

z

Mycoplasma

 

z

Uraemia (less common)

 

z

Hypersensitivity such as acute rheumatic fever,

myocardial infarction

 

z

Radiation

 

z

Trauma

 

z

Neoplasms

 

Clinical features

 

z

Pericardial inflammation: retrosternal pain

radiating to shoulder and much worse on deep

breathing, movement, change of position or

exercise

 

z

Pericardial rub is a diagnostic sign

 

z

Pericardial effusion: reduced cardiac impulses,

muffled heart sounds, acute cardiac compression

 

z

Effects on cardiac function: chronic constrictive

pericarditis, acute cardiac compression (cardiac

tamponade), dyspnoea, restlessness, rising

pulmonary and systemic venous pressure, rapid

heart rate, pulsus paradoxus, low BP and low

output cardiac failure.

 

Differential diagnosis

 

z

Any cause of central retrosternal chest pain eg.

pneumonia, ischaemic heart disease, peptic ulcer

 

Investigations

 

¾

ECG

¾

X-ray: chest

¾

Echo cardiography

 

UCG 2010

205

 

 

 

9. Cardiovascular diseases

Management H

 

f

According to cause and presenting clinical features

f

If there is fluid, perform tapping

 

Prevention

 

z

Early detection and treatment of infections

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