Uremic pericarditis history and symptoms
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Uremic pericarditis Microchapters |
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Diagnosis |
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Treatment |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S; Amandeep Singh M.D.[2]
Overview
Patients with pericarditis commonly present with chest pain that changes with position, cough, fever, breathlessness, and fatigue are the other common symptoms. Less common symptoms include palpitations, hiccup, odynophagia, faint, dizziness, and abdominal pain which is seen mostly in children.
History and Symptoms
- The majority of patients with uremic pericarditis are asymptomatic due to its slow progression.
- The hallmark of uremic pericarditis is chest pain which worsens on leaning forward and inspiration. A positive history of chronic kidney disease, chest pain and fever of unknown origin is suggestive of uremic pericarditis. The most common symptoms of uremic pericarditis include chest pain which worsens on leaning forward and inspiration.
History
Patients with uremic pericarditis may have a positive history of:
Common Symptoms
Common symptoms of pericarditis include:[1][2][3][4][5][6]
- Chest pain that improves on leaning forward and worsens on inspiration Chest pain is the most common symptom.
- Causes of pain include inflammation of the pericardium, phrenic nerves, and the nearby pleura.
- The pain is often initially sharp in nature, but it can be described as sticking, dull, aching, or pressure-like.
- Deep inspiration and cough can increase the pain so that the patient may sit upright for relief.
- Cough (either dry or productive)
- Fever
- Fatigue
- Anxiety
- Breathlessness
- Malaise
Less Common Symptoms
Less symptoms of pericarditis include:[7][8]
- Pain along the trapezius ridge(s), when present is very characteristic of pericarditis. The pain of myocardial infarction tends to involve the anterior precordium with radiation to the left arm.
- Palpitations
- Hiccup (rarely)
- Ankle edema
- Odynophagia with or without dysphagia
- Faintness and dizziness (uncommon unless cardiac tamponade is present)
- Abdominal pain (particularly in children)
Rapidity of Symptom Onset
Uremic pericarditis develops more slowly and can be undetectable until it presents as a fever of unknown origin.[9][10]
References
- ↑ Klein, Allan L.; Abbara, Suhny; Agler, Deborah A.; Appleton, Christopher P.; Asher, Craig R.; Hoit, Brian; Hung, Judy; Garcia, Mario J.; Kronzon, Itzhak; Oh, Jae K.; Rodriguez, E. Rene; Schaff, Hartzell V.; Schoenhagen, Paul; Tan, Carmela D.; White, Richard D. (2013). "American Society of Echocardiography Clinical Recommendations for Multimodality Cardiovascular Imaging of Patients with Pericardial Disease". Journal of the American Society of Echocardiography. 26 (9): 965–1012.e15. doi:10.1016/j.echo.2013.06.023. ISSN 0894-7317.
- ↑ Imazio, Massimo (2012). "Contemporary management of pericardial diseases". Current Opinion in Cardiology. 27 (3): 308–317. doi:10.1097/HCO.0b013e3283524fbe. ISSN 0268-4705.
- ↑ Imazio, Massimo; Gaita, Fiorenzo (2015). "Diagnosis and treatment of pericarditis". Heart. 101 (14): 1159–1168. doi:10.1136/heartjnl-2014-306362. ISSN 1355-6037.
- ↑ Imazio, M. (2011). "Pericardial involvement in systemic inflammatory diseases". Heart. 97 (22): 1882–1892. doi:10.1136/heartjnl-2011-300054. ISSN 1355-6037.
- ↑ Imazio, Massimo; Brucato, Antonio; Maestroni, Silvia; Cumetti, Davide; Belli, Riccardo; Trinchero, Rita; Adler, Yehuda (2011). "Risk of Constrictive Pericarditis After Acute Pericarditis". Circulation. 124 (11): 1270–1275. doi:10.1161/CIRCULATIONAHA.111.018580. ISSN 0009-7322.
- ↑ Banerjee A, Davenport A (2006). "Changing patterns of pericardial disease in patients with end-stage renal disease". Hemodial Int. 10 (3): 249–55. doi:10.1111/j.1542-4758.2006.00104.x. PMID 16805885.
- ↑ Doctor NS, Shah AB, Coplan N, Kronzon I (2017). "Acute Pericarditis". Prog Cardiovasc Dis. 59 (4): 349–359. doi:10.1016/j.pcad.2016.12.001. PMID 27956197.
- ↑ Soler-Soler J, Permanyer-Miralda G, Sagristà-Sauleda J (1990). "A systematic diagnostic approach to primary acute pericardial disease. The Barcelona experience". Cardiol Clin. 8 (4): 609–20. PMID 2249215.
- ↑ Comty, Christina M. (1971). "Pericarditis in Chronic Uremia and Its Sequels". Annals of Internal Medicine. 75 (2): 173. doi:10.7326/0003-4819-75-2-173. ISSN 0003-4819.
- ↑ Imazio, Massimo; Trinchero, Rita (2007). "Triage and management of acute pericarditis". International Journal of Cardiology. 118 (3): 286–294. doi:10.1016/j.ijcard.2006.07.100. ISSN 0167-5273.