Tuberculous pericarditis differential diagnosis

Written by Xiong Hong Hai

Infectious Disease

Updated on September 21, 2024

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The differential diagnosis of tuberculous pericarditis requires differentiation from other types of pericardial inflammation, such as bacterial pericarditis and nonspecific infections that lead to cellular inflammation of the pericardium. In addition to infections that can cause pericarditis, other infectious diseases such as subacute endocarditis and infections caused by other microbes can also lead to pericarditis. Furthermore, some rheumatic autoimmune diseases can also present with pericarditis. It is necessary to perform pericardiocentesis and fluid examination to determine the specific cause.

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Written by Li Hai Wen

Cardiology

44sec

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Symptoms of Acute Pericarditis

Acute pericarditis is not a common disease in daily life. What symptoms or clinical manifestations will appear after someone develops acute pericarditis? The clinical manifestations are mainly reflected in the following aspects: First, patients often experience chest pain and shortness of breath, and this pain often has a certain relationship with breathing. Second, the electrocardiogram often shows changes with ST segment elevation. Third, during a physical examination, doctors can often hear pericardial friction rub, or may feel the sensation of pericardial friction. Based on these symptoms and signs, doctors often make a diagnosis of acute pericarditis.

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Written by Tang Li

Cardiology

41sec

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What are the types of pericarditis?

Pericarditis includes primary infectious pericarditis, as well as non-infectious pericarditis caused by related diseases, such as tumors, metabolic diseases, autoimmune diseases, and uremia. Based on the progression of the condition, pericarditis can also be divided into acute pericarditis, with or without pericardial effusion, chronic pericarditis, adhesive pericarditis, subacute exudative constrictive pericarditis, and chronic constrictive pericarditis. Clinically, acute pericarditis and chronic constrictive pericarditis are the most common.

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Written by Tang Li

Cardiology

1min 42sec

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What are the symptoms of pericarditis?

Fibrinous pericarditis is primarily characterized by precordial pain, similar to that seen in acute nonspecific pericarditis and infectious pericarditis. Tuberculous or neoplastic pericarditis that develops slowly may not show obvious pain symptoms. The nature of the pain can be sharp and related to respiratory movements. It is often exacerbated by coughing, deep breathing, changing body position, or swallowing. The pain is located in the precordial area and may radiate to the neck, left shoulder, left arm, and left scapula, and can also reach the upper abdomen. The pain can be compressive and located behind the sternum. The most prominent symptom of exudative pericarditis is dyspnea, which may be associated with bronchopulmonary compression and pulmonary congestion. In severe cases of dyspnea, the patient may sit up to breathe, leaning forward, with rapid and shallow breathing and pale complexion. There may be hepatomegaly, as well as compression of the trachea and esophagus causing dry cough, hoarseness, and difficulty swallowing. Rapid pericardial effusion can lead to acute cardiac tamponade, presenting with significant tachycardia and decreased blood pressure. Reduced pulse pressure and increased venous pressure, if the cardiac output significantly drops, can lead to shock. If the fluid accumulates slowly, it could lead to subacute or chronic cardiac tamponade, characterized by systemic venous congestion and distended jugular veins.

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Written by Liu Yong

Cardiology

56sec

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Constrictive pericarditis causes hepatomegaly.

The so-called constrictive pericarditis refers to the presence of fibrotic calcifications and fibrotic hyperplasia in the pericardium, which severely affects the diastolic function of the heart. Once the diastolic function of the heart is compromised, the return flow of venous blood becomes severely obstructed, leading to congestion of the liver. Therefore, once congestion of the liver and spleen occurs, enlargement of the liver can occur, and in severe cases, it can lead to systemic edema, including ascites and similar conditions. Thus, the basic principle behind the enlargement of the liver in constrictive pericarditis is as such. Especially in such cases, patients will experience severe dietary problems, including poor appetite and indigestion, which further lead to low protein levels and malnutrition, exacerbating the enlargement of the liver and edema.

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Written by Liu Ying

Cardiology

1min 5sec

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acute pericarditis clinical manifestations

The clinical manifestations of acute pericarditis include symptoms and signs. The symptoms of acute pericarditis are pain behind the sternum and in the precordial region, which often occurs during the fibrinous exudative phase of inflammation. The pain can radiate to the neck, left shoulder, left arm, and even the upper abdomen. The nature of the pain is sharp, related to respiratory movements. As the condition progresses, the pain can disappear and be replaced by difficulty breathing. Some patients may develop significant pericardial effusion leading to cardiac tamponade, resulting in symptoms such as difficulty breathing, edema, and other related symptoms. During acute pericarditis, the most diagnostically valuable sign is the pericardial friction rub, typically located in the precordial area. A typical friction rub can be heard consistent with atrial contraction, ventricular contraction, and ventricular relaxation, known as a triphasic friction rub, and so on.