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| {{Infobox_Disease |
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| Name = {{PAGENAME}} |
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| Image = Mesothelial cyst of the pericardium.jpg|
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| Caption = Mesothelial cyst of the pericardium. Note the rounded mass in the right costophrenic angle (arrow). <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|
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| DiseasesDB = 9820 |
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| ICD10 = {{ICD10|I|01|0|i|00}}, {{ICD10|I|09|2|i|05}}, {{ICD10|I|30||i|30}}-{{ICD10|I|32||i|30}} |
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| ICD9 = {{ICD9|420.90}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = 000182 |
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| eMedicineSubj = med |
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| eMedicineTopic = 1781 |
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| eMedicine_mult = {{eMedicine2|emerg|412}} |
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| MeshName = Pericarditis |
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| MeshNumber = C14.280.720 |
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| }}
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| {{Template:Pericarditis}}
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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
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| {{WikiDoc Cardiology Network Infobox}}
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| {{CMG}}
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| __NOTOC__ | | __NOTOC__ |
| '''Associate Editor-In-Chief:''' {{CZ}} | | {| class="infobox" style="float:right;" |
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| | | [[File:Siren.gif|30px|link=Pericarditis resident survival guide]]|| <br> || <br> |
| | | [[Pericarditis resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']] |
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| | {{Patient}} |
| | {{Pericarditis}} |
| | {{CMG}}; {{AE}}{{Homa}}[[Varun Kumar, M.B.B.S.]]; {{CZ}} |
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| {{Editor Join}} | | {{SK}}[[acute pericarditis]], [[chronic pericarditis]], [[idiopathic pericarditis]], [[recurrent pericarditis]], [[chronic effusive pericarditis]], [[chronic constrictive pericarditis]], [[inflammation of the pericardium]], [[pericardial inflammation]], [[inflammation of the pericardial sac]], [[serous pericarditis]], [[purulent pericarditis]], [[hemorrhagic pericarditis]], [[fibrinous pericarditis]], [[caseous pericarditis]], [[bacterial pericarditis]], [[viral pericarditis]], [[fungal pericarditis]], [[parasitic pericarditis]], [[autoimmune pericarditis]], [[neoplastic pericarditis]], [[metabolic pericarditis]], [[traumatic pericarditis]], [[iatrogenic pericarditis]], [[drug-related pericarditis]], [[postoperative pericarditis]], [[post-operative pericarditis]], [[post-surgery pericarditis]], [[postsurgery pericarditis]], [[acute recurrent pericarditis]], [[radiation induced pericarditis]], [[radiation-induced pericarditis]], [[uremic pericarditis]], [[radiation induced constrictive pericarditis]], [[children pericarditis]], [[pericarditis in children]] |
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| ==[[Diseases of the pericardium overview | Overview]]== | | == [[Pericarditis overview|Overview]] == |
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| ==Pathophysiology & Etiology== | | == [[Pericardium|Pericardial Anatomy]] == |
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| [[Pericarditis overview of pathophysiology & etiology | Overview]] | [[Pericarditis causes | Pericarditis causes]] | | == [[Pericarditis classification|Classification]] == |
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| ==Differential Diagnosis for Diseases of the Pericardium ==
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| [[Pericarditis differential diagnosis | Pericarditis differential diagnosis]] | [[Acute Pericarditis | Acute Pericarditis]] | [[Chronic Pericarditis | Chronic Pericarditis]] | | == [[Pericarditis pathophysiology|Pathophysiology]] == |
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| == Clinical presentation == | | == [[Pericarditis causes|Causes]] == |
| [[Chest pain]], radiating to the back and relieved by sitting up forward and worsened by lying down, is the classical presentation. Other symptoms of pericarditis may include dry [[cough]], [[fever]], fatigue and [[anxiety]]. Pericarditis can be misdiagnosed as [[myocardial infarction]], and vice versa. | | [[HIV]] | [[Dressler's syndrome|Post-MI]] | [[Postpericardiotomy syndrome|Post-pericardiotomy]] | [[Radiation induced pericarditis|Radiation]] | [[Tuberculous pericarditis|Tuberculosis]] | [[Uremic pericarditis|Uremia]] | [[Pericarditis in malignancy|Malignancy]] |
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| The classic [[medical sign|sign]] of pericarditis is a [[pericardial rub|friction rub]]. Other signs include ST-elevation and PR-depression on [[Electrocardiogram|EKG]] (all leads); [[cardiac tamponade]] ([[pulsus paradoxus]] with [[hypotension]]), and [[congestive heart failure]] (elevated [[jugular venous pressure]] with [[peripheral edema]]).
| | == [[Pericarditis differential diagnosis|Differentiating Pericarditis from other Diseases]] == |
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| ==Natural History== | | == [[Pericarditis epidemiology and demographics|Epidemiology and Demographics]] == |
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| Most cases of acute idiopathic pericarditis resolve without complications or recurrence.
| | == [[Pericarditis natural history|Natural History, Complications and Prognosis]] == |
| Complications may include:
| | [[Pericardial effusion|Pericardial Effusion]] | [[Cardiac tamponade|Cardiac Tamponade]] | [[Constrictive pericarditis|Constrictive Pericarditis]] |
| * [[Pericardial effusion]]
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| * [[Constrictive pericarditis]]
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| * [[Cardiac tamponade]] [http://www.mayoclinic.com/invoke.cfm?objectid=CE3BC2CF-B4C1-4401-8F0F9E0B7C284538&dsection=6]
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| ==Types & Forms of Pericarditis== | | ==Diagnosis== |
| | [[Pericarditis history and symptoms|History and Symptoms]] | [[Pericarditis physical examination|Physical Examination]] | [[Pericarditis laboratory studies|Laboratory Findings]] | [[Pericarditis electrocardiogram|Electrocardiogram]] | [[Pericarditis EKG examples|EKG Examples]] | [[Pericarditis chest x ray|Chest X Ray]] | [[Pericarditis MRI|MRI]] | [[Pericarditis CT|CT]] | [[Pericarditis echocardiography|Echocardiography]] | [[Pericarditis other imaging findings|Other Imaging Findings]] |
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| * A. Congenital Diseases of the Pericardium
| | == Treatment == |
| :* [[Congenital absence of the pericardium]]
| | [[Pericarditis treatment|Medical Therapy]] | [[Pericardiocentesis]] | [[Pericardial window|Pericardial Window]] | [[Pericardial stripping|Pericardial Stripping]] | [[Treatment Related Videos]] |
| :* [[Pericardial cysts]]
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| * B. Acquired Diseases of the Pericardium
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| :* [[Pneumopericardium]]
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| == Diagnosis ==
| | == Case Studies == |
| | | [[Pericarditis case study one|Case #1]] |
| [[Pericarditis history and symptoms| History and Symptoms]] | [[Pericarditis physical examination | Physical Examination]] | [[Pericarditis laboratory findings | Laboratory Findings]]
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| ==[[Pericarditis treatment| Treatment]]==
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| ==[[Pericarditis Pharmacotherapies | Pharmacotherapies]]==
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| == Surgical and Device Based Therapies ==
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| ===[[Pericardiocentesis]]===
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| ===[[A thoracoscopic approach to creating a pericardial window]]===
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| ===[[A surgical subxiphoid incision to create a pericardial window]]===
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| ===[[Pericardial Stripping for Constrictive Pericarditis]]===
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| ===[[Treatment Related Videos]]===
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| ==[[Pericarditis Complications | Complications]]==
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| ==Case Examples== | |
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| ===[[Pericarditis Case #1 | Case #1]]===
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| ==See Also==
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| | == Related Chapters == |
| | * [[Chylopericardium]] |
| | * [[Congenital absence of the pericardium]] |
| * [[Hemopericardium]] | | * [[Hemopericardium]] |
| * [[Pneumopericardium]] | | * [[Pneumopericardium]] |
| * [[Chylopericardium]]
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| * [[Pericardial effusion]] | | * [[Pericardial effusion]] |
| * [[Congenital absence of the pericardium]]
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| * [[Pericardial window]] | | * [[Pericardial window]] |
| | * [[Cardiac tamponade]] |
| | * [[Constrictive pericarditis]] |
| * [[Pericardial sac]] | | * [[Pericardial sac]] |
| * [[Pericardial friction rub]] | | * [[Pericardial friction rub]] |
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| * [[Pericardium]] | | * [[Pericardium]] |
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| ==Source==
| | {{Circulatory system pathology}} |
| | | {{WH}} |
| * [http://www.ngc.gov/summary/summary.aspx?doc_id=4960&nbr=003524&string=Cardiac+AND+Tamponade National Guideline Clearinghouse]
| | {{WS}} |
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| ==References==
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| {{Reflist|2}} | |
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| == Acknowledgements ==
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| The content on this page was first contributed by [[C. Michael Gibson, M.S., M.D.]]
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| ==Additional Resources==
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| {{refbegin|2}} | |
| * Adler Y, Finkelstein Y, Guindo J, de la Serna R, Shoenfeld Y, Bayes-Genis A, Sagie A, Bayes de Luna A, Spodick DH. Colchicine treatment for recurrent pericarditis: a decade of experience. Circulation. 1998;97:2183–2185.
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| * Applegate RJ, Johnston WE, Vinten-Johansen J, Klopfenstein HS, Little WC. Restraining effect of intact pericardium during acute volume leading. Am J Physiol. 1992;262:H1725–H1733.
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| * Artom G, Koren-Morag N, Spodick DH, Brucato A, Guindo J, Bayesde-Luna A, Brambilla G, Finkelstein Y, Granel B, Bayes-Genis A, Schwammenthal E, Adler Y. Pretreatment with corticosteroids attenuates the efficacy of colchicine in preventing recurrent pericarditis: a multicentre all-case analysis. Eur Heart J. 2005;26:723–727.
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| * Arunasalam S, Siegel RJ. Rapid resolution of symptomatic acute pericarditis with ketorolac tromethamine: a parenteral nonsteroidal antiinflammatory agent. Am Heart J. 1993;125(pt 1):1455–1458.
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| * Bonnefoy E, Gordon P, Kirkorian G, Fatemi M, Chevalier P, Touboul P. Serum cardiac troponin I and ST-segment elevation in patients with acute pericarditis. Eur Heart J. 2000;21:832–836.
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| * Correale E, Maggioni AP, Romano S, Ricciardiello V, Battista R, Salvarola G, Santoro E, Tognoni G, on behalf of the Gruppo Italiano perlo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI). Comparison of frequency, diagnostic and prognostic significance of pericardial involvement in acute myocardial infarction treated with and without thrombolytics. Am J Cardiol. 1993;71:1377–1381.
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| * Fowler NO. Tuberculous pericarditis. JAMA. 1991;266:99 –103.
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| * Freeman GL, LeWinter MM. Determinants of the intrapericardial pressure in dogs. J Appl Physiol. 1986;60:758 –764.
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| * Freeman GL, LeWinter MM. Pericardial adaptations during chronic cardiac dilation in dogs. Circ Res. 1984;54:294 –300.
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| * Freeman GL, Little WC. Comparison of in situ and in vitro studies of pericardial pressure-volume relation in the dog. Am J Physiol. 1986;251: H421–H427.
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| * Gunukula SR, Spodick DH. Pericardial disease in renal patients. Semin Nephrol. 2001;21:52–56.
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| * Hoit BD, Gabel M, Fowler NO. Cardiac tamponade in left ventricular dysfunction. Circulation. 1990;82:1370–1376.
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| * Imazio M, Bobbio M, Cecchi E, Demarie D, Demichellis B, Pomari F, Moratti M, Gaschino G, Giammaria M, Ghiso A, Belli R, Trinchero R. Colchicine in addition to conventional therapy for acute pericarditis: results of the COlchicine for acute PEricarditis (COPE) Trial. Circulation. 2005;112:2012–2016.
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| * Imazio M, Demichellis B, Cecchi E, Belli R, Ghisio A, Bobbio M, Trinchero R. Cardiac troponin I in acute pericarditis. J Am Coll Cardiol. 2003;42:2144–2148.
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| * Imazio M, Demichellis B, Parrini I, Gluggia M, Cecchi E, Gaschino G, Demarie D, Ghislo A, Trinchero R. Day-hospital treatment of acute pericarditis: a management program for outpatient therapy. J Am Coll Cardiol. 2004;43:1042–1046.
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| * Jerjes-Sanchez C, Ramirez-Rivera A, Ibarra-Perez C. The Dressler syndrome after pulmonary embolism. Am J Cardiol. 1996;78:343–345.
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| * Kansal S, Roitman D, Sheffield LT. Two-dimensional echocardiography of congenital absence of pericardium. Am Heart J. 1985;109:912–915.
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| * Klopfenstein HS, Schuchard GH, Wann LS, Palmer TE, Hartz AJ, Gross CM, Singh S, Brooks HL. The relative merits of pulsus paradoxus and right ventricular diastolic collapse in the early detection of cardiac tamponade: an experimental echocardiographic study. Circulation. 1985;71: 829–833.
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| * Knopf WD, Talley JD, Murphy DA. An echo-dense mass in the pericardial space as a sign of left ventricular free wall rupture during acute myocardial infarction. Am J Cardiol. 1987;59:1202.
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| * Lange RA, Hillis D. Acute pericarditis. N Engl J Med. 2004;351: 2195–2202.
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| * LeWinter MM, Kabbani S. Pericardial diseases. In: Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald’s Heart Disease. 7th ed. Philadelphia, Pa: Elsevier Saunders; 2005:1757–1780.
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| * Maisch B, Ristic D, Pankuweit S. Intrapericardial treatment of autoreactive pericardial effusion with triamcinolone. Eur Heart J. 2002;23: 1503–1508.
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| * Maisch B, Seferovic PM, Ristic AD, Erbel R, Rienmuller R, Adler Y, Tomkowski WZ, Thiene G, Yacoub MH, for the Task Force on the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology. Guidelines on the diagnosis and management of pericardial diseases: executive summary. Eur Heart J. 2004;25:587– 610.
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| * Maisch B. Recurrent pericarditis: mysterious or not so mysterious? Eur Heart J. 2005;26:631– 633.
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| * Mandell BF. Cardiovascular involvement in systemic lupus erythematosus. Semin Arthritis Rheum. 1987;17:126 –141.
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| * Miyazaki T, Pride HP, Zipes DP. Prostaglandins in the pericardial fluid modulate neural regulation of cardiac electrophysiological properties. Circ Res. 1990;66:163–175.
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| * Park JH, Choo SJ, Park SW. Acute pericarditis caused by acrylic bone cement after percutaneous vertebroplasty. Circulation. 2005; 111:e98.
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| * Permanyer-Miralda G, Sagrista-Sauleda J, Soler-Soler J. Primary acute pericardial disease: a prospective series of 231 consecutive patients. Am J Cardiol. 1985;56:623– 630.
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| * Permanyer-Miralda G. Acute pericardial disease: approach to the aetiologic diagnosis. Heart. 2004;90:252–254.
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| * Reddy PS, Curtiss EI, O’Toole JD, Shaver JA. Cardiac tamponade: hemodynamic observations in man. Circulation. 1978;58:265–272.
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| * Reddy PS, Curtiss EI, Uretsky BF. Spectrum of hemodynamic changes in cardiac tamponade. Am J Cardiol. 1990;66:1487–1491.
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| * Shabetai R, Fowler NO, Guntheroth WG. The hemodynamics of cardiac tamponade and constrictive pericarditis. Am J Cardiol. 1970;26: 480–489.
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| * Shabetai R. Pericardial effusion: haemodynamic spectrum. Heart. 2004; 90:255–256.
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| * Shabetai R. Recurrent pericarditis: recent advances and remaining questions. Circulation. 2005;112:1921–1923.
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| * Singh S, Wann S, Schuchard GH, Klopfenstein HS, Leimgruber PP, Keelan MH, Brooks HL. Right ventricular and right atrial collapse in patients with cardiac tamponade: a combined echocardiographic and hemodynamic study. Circulation. 1984;70:966–971.
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| * Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003;349: 684–690.
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| * Spodick DH. Acute pericarditis: current concepts and practice. JAMA. 2003;289:1150 –1153.
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| * Spodick DH. Intrapericardial treatment of persistent autoreactive pericarditis / myopericarditis and pericardial effusion. Eur Heart J. 2002;23: 1481–1482.
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| * Spodick DH. Macrophysiology, microphysiology, and anatomy of the pericardium: a synopsis. Am Heart J. 1992;124:1046 –1051.
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| * Troughton RW, Asher CR, Klein AL. Pericarditis. Lancet. 2004;363: 717–727.
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| * Tsang TS, Barnes ME, Hayes SN, Freeman WK, Dearani JA, Butler SL, Seward JB. Clinical and echocardiographic characteristics of significant pericardial effusions following cardiothoracic surgery and outcomes of echo-guided pericardiocentesis for management: Mayo Clinic experience, 1979–1998. Chest. 1999;116:322–331.
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| * Tsang TS, Oh JK, Seward JB, Tajik AJ. Diagnostic value of echocardiography in cardiac tamponade. Herz. 2000;25:734–740.
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| * Zayas R, Anguita M, Torres F, Gimenez D, Bergillos F, Ruiz M, Ciudad M, Gallardo A, Valles F. Incidence of specific etiology and role of methods for specific etiologic diagnosis of primary acute pericarditis. Am J Cardiol. 1995;75:378 –382.
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| {{refend}} | |
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| == Suggested Links and Web Resources ==
| | [[Category:Medicine]] |
| * [http://www.mayoclinic.com/invoke.cfm?objectid=CE3BC2CF-B4C1-4401-8F0F9E0B7C284538&dsection=1 Pericarditis] - Mayo Clinic series
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| * [http://cardiologychannel.com/pericarditis/diagnosis.shtml Pericarditis] - cardiologychannel.com
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| * [http://heartcenter.seattlechildrens.org/conditions_treated/pericarditis.asp Pericarditis information] from Seattle Children's Hospital Heart Center
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| * [http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2002;volume=48;issue=1;spage=46;epage=9;aulast=Khasnis Pulsus paradoxus] - Journal of Postgraduate Medicine
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| * http://en.wikipedia.org/wiki/Pericarditis
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| * [http://www.SeeMyHeart.org SeeMyHeart] - Patient Information on Echocardiograms (Heart Ultrasounds)
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| * [http://www.asecho.org American Society] of Echocardiography
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| * [http://www.ptca.org/imaging/stress_test.html Stress Test with Echocardiography] from Angioplasty.Org
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| * [http://heartcenter.seattlechildrens.org/what_to_expect/echocardiogram.asp Echocardiography information] from Children's Hospital Heart Center, Seattle.
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| * [http://know-heart-diseases.com Coronary heart disease] And echocardiography
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| * [http://www.echocardiology.org Echocardiography Resources] Simple echocardiography tutorials
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| * [http://www.manbit.com/ERS/ERSindex.asp Atlas of Echocardiography] Echocardiography Database
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| * [http://www2.umdnj.edu/~shindler/index.html E-chocardiography] Internet Journal of Cardiac Ultrasound
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| * [http://www.echobasics.de Echobasics] Basic introduction to echocardiography - German/Spanish English planned for 2007
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| * [http://www.mitral.com/echocardiography.shtml Echocardiography] Basic information about echocardiography - HealthwoRx
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| == For Patients ==
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| * [http://www.mssm.edu/cvi/pericarditis.shtml#q1 Pericarditis]
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| {{Electrocardiography}}
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| {{Circulatory system pathology}}
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| {{SIB}}
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| [[Category:Cardiology]] | | [[Category:Cardiology]] |
| [[Category:Diseases involving the fasciae]] | | [[Category:Up-To-Date]] |
| [[Category:Inflammations]]
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| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
| | | [[Category:Intensive care medicine]] |
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| [[de:Perikarditis]] | |
| [[es:Pericarditis]]
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| [[pl:Zapalenie osierdzia]]
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| [[pt:Pericardite]]
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| [[sv:Hjärtsäcksinflammation]]
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| [[tr:Perikard hastalıkları]]
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