Pericarditis (internal)

Pericarditis are inflammatory diseases of the pericardium.
 * They occur either as' acute inflammation with effusion (danger cardiac tamponade) or aschronic inflammation with pericardial fibrosis (risk of cardiac constriction).
 * They are part of systemic diseases (that's why we monitor patients for a long time even after they have disappeared).

Acute pericarditis

 * 2 forms:
 * dry, fibrinous - chest pain, pericardial friction murmur, ECG changes (typical pericardial changes of ST - T sections);
 * exsudative - effusion (diagnosed echocardiographically) ;
 * often takes place without clinical manifestations;
 * etiology: most often viral, we must always think of the tumor etiology;
 * therapy: symptomatic, according to etiology, ev. ATB, sometimes corticotherapy is required;
 * the prognosis is favorable;
 * if there is a larger effusion, a cardiac tamponade follows (shortness of breath, low cardiac output, paradoxical pulse - we hear weakened sounds, on X-ray dilatation of the heart shadow);
 * we must also think about the effusion in the first month after the heart defect operation.

Etiology

 * Idiopathic;
 * infectious: viruses (coxsackie A, B, mononucleosis, hepatitis B, AIDS, cytomegalovirus), bacteria (pneumococci, styphylococci, streptococci)…;
 * acute myocardial infarction (pericarditis epistenocardiaca above the lesion);
 * uremia;
 * cancer (lung cancer, breast cancer, leukemia,…);
 * autoimmune diseases;
 * sarcoidosis, intestinal inflammation, amyloidosis;
 * drug (hydralazine, procainamide, isoniaside, diphenylhydanthione, ..);
 * post-traumatic: chest trauma (hemopericardium,…);
 * postoperative: postpericardiotomy syndrome
 * myxedema;
 * chylopericard .

Constrictive pericarditis ( pericarditis constrictiva )

 * Definition: a chronic condition in which a rigid pericardium barrier impedes normal filling heart blood ;
 * Consequence: decreased cardiac output and marked blood congestion in the liver;
 * Clinical picture: shortness of breath, fatigue, later swelling lower limbs, ascites, anorexia, weight loss, dyspepsia ;
 * in children it is very rare, in the past it was often with tbc inflammation;
 * it is very difficult to distinguish this condition from restrictive KMP.

Related Articles

 * Infectious endocarditis
 * Myocarditis
 * Pericarditis (pathology)
 * Pericarditis (pediatrics)

Source

 * BENEŠ, Jiří. Studijní materiály [online]. ©2007. [cit. 2010]. .