Symptoms of Acute Pericarditis

Written by Li Hai Wen
Cardiology
Updated on August 31, 2024
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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 Liu Ying
Cardiology
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Constrictive pericarditis clinical manifestations

Patients with constrictive pericarditis often have a history of pericarditis, pericardial effusion, malignant tumors, and other diseases. Some patients have an insidious onset with no obvious clinical symptoms in the early stages. The main symptoms can include palpitations, exertional dyspnea, decreased exercise tolerance, fatigue, enlarged liver, pleural effusion, abdominal effusion, and edema of the lower limbs. Patients with constrictive pericarditis commonly present with elevated jugular venous pressure, and often have a reduced pulse pressure. Most patients exhibit a negative apical beat during systole, with a commonly faster heart rate. The rhythm can be sinus, atrial, or ventricular, with premature contractions possible, as well as Kussmaul's sign. In the late stages, muscle atrophy, cachexia, and severe edema can occur.

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Cardiology
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Can acute pericarditis be cured?

Patients with acute pericarditis should identify the cause of pericarditis and treat accordingly, rest in bed until chest pain and fever subside, administer analgesics for pain relief, and if pericardial effusion occurs, administer corticosteroids for patients who do not respond well to other medications for absorbing effusion. In cases of excessive pericardial effusion leading to acute cardiac tamponade, immediate pericardiocentesis and fluid drainage are necessary. For persistent recurrent pericarditis lasting over two years, and in patients who cannot be controlled with steroids, or those with severe chest pain, surgical pericardiectomy may be considered as a treatment option.

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Written by Tang Li
Cardiology
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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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Early symptoms of acute pericarditis

The early symptoms of acute pericarditis are pain, which is located behind the sternum or in the precordial area, typically seen in the fibrin exudative type of inflammation. This pain arises from the friction between the visceral pericardium and the parietal pericardium. The nature of the pain is very sharp and related to respiratory movement, commonly exacerbated by coughing, deep breathing, or swallowing. The pain can radiate to the neck, left shoulder, and left arm. As fluid accumulates in the pericardium and the two layers of the pericardium separate, the pain may decrease or disappear.

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What are the infectious causes of pericarditis?

The causes of pericarditis include the following types: first, acute nonspecific; second, tumors; third, autoimmune disorders; fourth, metabolic diseases; fifth, physical factors such as trauma and radiation; sixth, diseases of adjacent organs and tissues, such as acute myocardial infarction, pleurisy, aortic dissection, pulmonary embolism, etc. The infectious causes of acute pericarditis mainly include viruses, bacteria, fungi, parasites, and rickettsiae. Common types of pericarditis include tuberculous pericarditis and purulent pericarditis.