acute pericarditis clinical manifestations

Written by Liu Ying
Cardiology
Updated on September 03, 2024
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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.

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Written by Li Hai Wen
Cardiology
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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 Liu Ying
Cardiology
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Treatment of constrictive pericarditis

Constrictive pericarditis refers to a disease in which the heart is surrounded by a densely thickened fibrotic or calcified pericardium, restricting ventricular diastolic filling and producing a series of circulatory disorders, typically chronic in nature. In China, the most common cause of constrictive pericarditis is tuberculosis. Constrictive pericarditis is a progressive disease, and most patients will develop chronic constrictive pericarditis. At this stage, pericardiectomy is the only effective treatment method. It should be performed early to avoid complications such as cardiac cachexia, severe liver dysfunction, and myocardial atrophy, with surgery usually carried out after controlling the pericardial infection. For tuberculosis patients, anti-tuberculosis treatment should continue for one year after surgery.

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Written by Liu Ying
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 Li Hai Wen
Cardiology
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Is pericarditis serious?

Pericarditis refers to a group of diseases mainly characterized by inflammation and effusion of the pericardium. The severity of pericarditis depends on the condition of the disease. Firstly, if the inflammation and effusion of the pericardium are not severe, patients often experience symptoms such as chest tightness or chest pain. In general, this type of pericarditis is not considered severe. Secondly, if the inflammation and effusion of the pericardium are more pronounced, it can lead to pericardial effusion, especially in cases of large amounts of pericardial fluid. At this time, the condition is often quite serious, and it is essential to undergo formal treatment under the guidance of a doctor, including pericardial drainage therapy.

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Written by Liu Ying
Cardiology
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How is constrictive pericarditis treated?

We say constrictive pericarditis refers to a disorder of circulatory disturbances caused by the heart being encased in a densely thickened fibrotic or calcified pericardium, which restricts the filling of the ventricles during diastole. Most patients with constrictive pericarditis will progress to chronic constrictive pericarditis. At this point, the only effective treatment method is pericardiectomy, but the perioperative risk is very high. A small portion of patients have short-term or reversible pericardial constriction, so for patients who are recently diagnosed and have stable conditions, it is possible to try anti-inflammatory treatment for 2-3 months unless complications such as cardiac cachexia, cardiogenic cirrhosis, or myocardial atrophy occur. For tuberculous pericarditis, anti-tuberculosis treatment is recommended to delay the progression of pericardial constriction, and post-surgery, anti-tuberculosis treatment should continue for one year.