Acute Pericarditis Questions & Answers

Updated: Jan 24, 2017
  • Author: Sean Spangler, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Questions & Answers

Overview

What is acute pericarditis?

What are the signs and symptoms of acute pericarditis?

What are specific causes of acute pericarditis?

What is included in the initial evaluation of acute pericarditis?

What electrocardiogram (ECG) findings are characteristic of acute pericarditis?

When is an ECG indicated for the diagnosis of acute pericarditis?

What is the role of a chest radiograph in the diagnosis of acute pericarditis?

What is the role of lab testing in the diagnosis of acute pericarditis?

What is the focus of treatment for acute pericarditis?

Which drugs are used in the treatment of acute pericarditis?

What is the role of corticosteroids in the treatment of acute pericarditis?

What is the role of surgery in the treatment of acute pericarditis?

What is the role of pericardiectomy in the treatment of acute pericarditis?

When is pericardiocentesis indicated in the treatment of acute pericarditis?

What is the role of pericardial window placement in the treatment of acute pericarditis?

What is the role of subxiphoid pericardiotomy in the treatment of acute pericarditis?

What is acute pericarditis?

What heart anatomy is involved in acute pericarditis?

What are the main functions of pericardial physiology?

What is the pathophysiology of acute pericarditis?

What is uremic pericarditis?

What is the pathophysiology of acute pericarditis caused by bacterial infection?

What are the possible underlying causes of acute pericarditis?

What are the types of pericarditis?

What causes serous pericarditis?

What is the most frequent type of acute pericarditis?

What are the clinical features of purulent or suppurative pericarditis?

What is hemorrhagic pericarditis?

What is caseous pericarditis?

What is adhesive mediastinopericarditis?

What causes constrictive pericarditis?

What is the role of cardiac tamponade in the etiology of pericarditis?

When is aggressive resuscitation indicated in the treatment of acute pericarditis?

What is the role of iatrogenic cardiac perforation in the etiology of tamponade?

What is the first manifestation of dermatopolymyositis?

What are the specific causes of acute pericarditis?

What is the prevalence of idiopathic pericarditis?

How is chronic idiopathic pericarditis defined?

What is the most common cause of acute pericarditis?

Which viruses cause acute pericarditis?

What is the role of HIV infection in the etiology of acute pericarditis?

Which bacterial organisms most commonly cause acute pericarditis?

Which bacterial organisms are less common causes of acute pericarditis?

What is the etiologic role of anaerobes in acute pericarditis?

What used to be the predominant bacteria to cause acute pericarditis?

What is the role of tuberculosis in the etiology of acute pericarditis?

Which fungal organisms cause acute pericarditis?

What causes uremic pericarditis?

What is the role of putative toxins in the etiology of uremic pericarditis?

What is the role of azotemia in the pathogenesis of uremia pericarditis?

What are the types of pericarditis in patients with renal failure?

What is the most effective treatment for dialysis-associated pericarditis?

What is the role of rheumatoid arthritis (RA) in the etiology of acute pericarditis?

What is the role of systemic lupus erythematosus (SLE) in the etiology of acute pericarditis?

What is the role of scleroderma in the etiology of acute pericarditis?

What is the role of sarcoidosis in the etiology of acute pericarditis?

What is the role of rheumatic fever in the etiology of acute pericarditis?

Which conditions may cause acute pericarditis?

What is the role of renal failure in the etiology of pericarditis?

What is the prevalence of pericarditis caused by renal failure?

What is the role of pericardial effusions in the etiology of pericarditis?

What is the role of hypothyroidism in the etiology of acute pericarditis?

What is cholesterol pericarditis?

What is the role of myocardial infarction (MI) in the etiology of acute pericarditis?

What is the role of Dressler syndrome in the etiology of acute pericarditis?

What is the prevalence of acute pericarditis caused by aortic dissection?

What is the etiologic relationship between Takotsubo cardiomyopathy and acute pericarditis?

What is the prevalence of malignancy in acute pericarditis?

What is the role of neoplasms in the etiology of acute pericarditis?

Which malignancies are associated with acute pericarditis?

What is the prevalence of acute pericarditis caused by lung cancer?

What is the role of medications in the etiology of acute pericarditis?

What is the role of radiation therapy in the etiology of acute pericarditis?

What is the role of invasive cardiac procedures in the etiology of acute pericarditis?

What is the role of trauma in the etiology of acute pericarditis?

What is the incidence of acute pericarditis?

What is the incidence of uremic pericarditis?

How common is malignant disease in acute pericarditis?

How does the incidence of acute pericarditis vary by sex and age?

What is the prognosis of acute pericarditis?

What are poor prognostic factors in acute pericarditis?

Which factors increase the risk for development of complicated pericarditis?

Which clinical features indicate a poor prognosis for acute pericarditis?

What is the prognosis of uremic pericarditis?

What is the prognosis of acute pericarditis caused by penetrating injuries?

Presentation

How is pain in acute pericarditis characterized?

What are the signs and symptoms of acute pericarditis?

What is the presentation of acute pericarditis in children?

What is the characteristic history of patients who present with symptomatic rheumatoid arthritis (RA) pericarditis?

What are the signs and symptoms of uremic pericarditis?

What are the signs and symptoms of cardiac tamponade in acute pericarditis?

What does a waxing and waning clinical presentation of acute pericarditis suggest?

What is the significance of a pericardial friction rub in the evaluation of acute pericarditis?

How is pericardial friction rub identified during physical exam for acute pericarditis?

What are the different phases of pericardial friction rub in acute pericarditis?

What is the significance of a biphasic pericardial friction rub in the evaluation of acute pericarditis?

What is the significance of a monophasic pericardial friction rub in the evaluation of acute pericarditis?

Which physical findings are characteristic of acute pericarditis?

What is the significance of the Beck triad in the evaluation of acute pericarditis?

How is pulsus paradoxus identified in the evaluation of acute pericarditis?

DDX

What conditions can be confused with the classic features of acute pericarditis?

Which factors are associated with finding a specific etiology for acute pericarditis?

Which pericardial effusions may not require evaluation for acute pericarditis?

How is tension pneumothorax differentiated from acute pericarditis?

What is the role of central venous pressure (CVP in the diagnosis of acute pericarditis?

How is acute pericarditis distinguished from myocardial infarction (MI)?

Which electrocardiogram (ECG) findings are helpful in narrowing the differential diagnosis of acute pericarditis?

What are the differential diagnoses for Acute Pericarditis?

Workup

What is a diagnostic workup protocol for acute pericarditis?

How is tension pneumothorax differentiated from acute pericarditis?

If echocardiography is unavailable, what alternative test can be used to diagnose acute pericarditis?

How is rheumatoid arthritis (RA) pericarditis diagnosed?

How is rheumatic fever pericarditis diagnosed?

How is tuberculous pericarditis diagnosed?

How is neoplastic pericarditis diagnosed?

How are malignant pericardial effusions controlled in acute pericarditis?

Which lab tests are performed in the evaluation of acute pericarditis?

What is the role of a CBC count in the diagnosis of acute pericarditis?

What is the role of serum electrolyte levels in the diagnosis of acute pericarditis?

What is the role of blood urea nitrogen (BUN) and creatinine levels in the diagnosis of acute pericarditis?

What is the role of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels in the diagnosis of acute pericarditis?

What is the role of cardiac biomarkers in the evaluation of acute pericarditis?

Which lab tests may be indicated in the diagnosis of acute pericarditis based on suspected etiology?

What is the role of chest radiography in the diagnosis of acute pericarditis?

What are characteristics of "swinging heart" in patients with acute pericarditis?

What is the role of echocardiography in the diagnosis of acute pericarditis?

What are the characteristic findings of pericardial inflammation and pericardial effusion on echocardiography in the evaluation of acute pericarditis?

What is the role of M-mode echocardiography in the diagnosis of acute pericarditis?

How are effusions defined on echocardiogram in the diagnosis of acute pericarditis?

What is the prevalence of pericardial effusion in rheumatoid arthritis pericarditis?

How is a cardiac tamponade diagnosed in in trauma patients?

What is the role of CT scanning in the diagnosis of acute pericarditis?

How is CT scanning used to detect effusions in the diagnosis of acute pericarditis?

What is the significance of epicardial fat volume (EFV) in the diagnosis of acute pericarditis?

What are the benefits of CT scanning for the diagnosis of acute pericarditis?

What are the limitations of CT scanning for the diagnosis of acute pericarditis?

What is the role of MRI in the diagnosis of acute pericarditis?

What are the limitations of MRI in the diagnosis of acute pericarditis?

What is the role of ECG in the diagnosis of acute pericarditis?

What is an important electrocardiogram (ECG) finding in acute pericarditis?

What is the significance of electrical alternans in the diagnosis of acute pericarditis?

What are the characteristics of stage 1 ECG findings in the diagnosis of acute pericarditis?

What are the characteristics of stage 2 ECG findings in the diagnosis of acute pericarditis?

What are the characteristics of stage 3 ECG in the diagnosis of acute pericarditis?

What are the characteristics in stage 4 ECG in the diagnosis of acute pericarditis?

Which ECG findings are characteristic of idiopathic acute pericarditis?

Which ECG findings in the evaluation of acute pericarditis are characteristic of underlying inflammatory disorders?

Which ECG findings in the evaluation of acute pericarditis are characteristic of underlying cardiovascular disorders?

What is the safety of pericardiocentesis for the diagnosis of acute pericarditis?

What is the accuracy of pericardiocentesis for the diagnosis of acute pericarditis?

What are the ESC diagnostic guidelines for viral pericarditis?

How is traditional pericardiocentesis performed for the diagnosis of acute pericarditis?

What is the role of echocardiographically guided pericardiocentesis in the diagnosis of acute pericarditis?

What is the step-by-step approach to echocardiographically-guided pericardiocentesis in the diagnosis of acute pericarditis?

How is pericardial fluid analyzed in the diagnosis of acute pericarditis?

How is the pericardial fluid characterized in the diagnosis of purulent or suppurative pericarditis?

How is the pericardial fluid characterized in diagnosis of acute pericarditis with an underlying inflammatory disorder?

How is the pericardial fluid characterized in diagnosis of uremic pericarditis?

What is the role of pericardial biopsy in the diagnosis of acute pericarditis?

What is the role of cardiac catheterization in the diagnosis of acute pericarditis?

Treatment

What is the initial treatment approach for acute pericarditis?

What should be avoided in the treatment of acute MI pericarditis?

What is the treatment approach for complicated pericarditis?

What are the hospital requirements for patients with acute pericarditis?

What is included in the prehospital care of acute pericarditis?

What are the goals of emergency care of acute pericarditis?

What is included in the emergency department (ED) care of acute pericarditis?

What is included in the emergency department (ED) care of cardiac tamponade?

How is idiopathic pericarditis treated?

How is viral pericarditis treated?

How is fungal pericarditis treated?

What is the role of intrapericardial fibrinolysis in the treatment of acute pericarditis?

How is tubular infection managed in acute pericarditis?

What is the role of steroids in the treatment of tuberculous pericarditis?

How is rheumatoid arthritis (RA) pericarditis treated?

How is rheumatic fever pericarditis treated?

When is dialysis indicated in the treatment of acute pericarditis?

What is the role of hemodialysis and peritoneal dialysis in the treatment of acute pericarditis?

What are the dialysis recommendations in the treatment of acute pericarditis?

Which drugs are used to provide symptomatic relief in acute pericarditis?

What measures may prevent uremic pericarditis?

How is hypothyroidism-associated pericarditis treated?

What are the European Society of Cardiology (ESC) treatment guidelines for metabolic pericarditis?

What are the treatment options for cardiovascular pericarditis?

What is the treatment for neoplasm-associated pericarditis?

What are the European Society of Cardiology (ESC) guidelines for the prevention of recurrence of neoplastic pericarditis?

What are the European Society of Cardiology (ESC) treatment guidelines for neoplastic pericardial effusion without tamponade?

How is drug-induced pericarditis treated?

What is the role of colchicine in the treatment of acute pericarditis?

What are the dietare restrictions for patients with acute pericarditis?

What are the activity restrictions for patients with acute pericarditis?

Which surgical interventions are used in the treatment of acute pericarditis?

What is the role of pericardiectomy in the treatment of acute pericarditis?

When is pericardiectomy indicated for the treatment of acute pericarditis?

What factor increases the failure rates for pericardiectomy in the treatment of acute pericarditis?

What is the operative mortality rate for pericardiectomy in the treatment of acute pericarditis?

What can increase the diagnostic yield for pericardiectomy in acute pericarditis?

What is the prognosis of surgery for acute pericarditis?

When is pericardiocentesis indicated for the treatment of acute pericarditis?

What is the role of a balloon catheter in the treatment of acute pericarditis?

What is the role of pericardial window placement in the treatment of acute pericarditis?

What is the role of pericardiotomy in the treatment of acute pericarditis?

What are possible complications of acute pericarditis or the treatments used in its management?

Which specialist consultations are needed for the treatment of acute pericarditis?

Medications

What is the focus of treatment for acute pericarditis?

How are NSAIDs used in the treatment of acute pericarditis?

When is aspirin indicated in the treatment of acute pericarditis?

What is the role of corticosteroids in the treatment of acute pericarditis?

What is the role of colchicine in the treatment of acute pericarditis?

When are corticosteroids indicated for the treatment of acute pericarditis?

Which medications in the drug class Corticosteroids are used in the treatment of Acute Pericarditis?

Which medications in the drug class Salicylates are used in the treatment of Acute Pericarditis?

Which medications in the drug class Anti-inflammatory agents are used in the treatment of Acute Pericarditis?

Which medications in the drug class Nonsteroidal anti-inflammatory drugs are used in the treatment of Acute Pericarditis?