DEFINITION

The pericarditis is an illness inflammatory that it affects to the pericardium that is the exterior covering of the heart. It is a frequent illness between adults from 20 to 50 years after viral infections, but it can appear at any age.

CAUSES

The pericarditis generally stems from viral infections, between them the produced ones by the virus ecovirus, the virus coxsackie, the virus of the flu and sometimes for the virus of the AIDS (HIV).

SYMPTOMS

The pericarditis appears with the following symptoms:

• Shooting pain in the breast that it improves on having sat down or inclining ahead.
• This pain deteriorates with the respiration and on having gone to bed, with the cough and on having eaten.
• The pain can be radiated to the neck, to the shoulder, to the back or to the abdomen.
• A shortness of breath or difficulty appears to breathe, especially on having been knocked down, improving standing.
• A dry cough arises.
• Distension of ankles, feet and legs.
• Anxiety.
• Fever

DIAGNOSIS

In a patient with these symptoms, on having auscultated, the doctor will perceive a typical rubbing of the pericardium and on the other hand the cardiac noises can be perceived as as extinguished.

If the illness is advanced, there can be crackling noises at pulmonary level, decrease of the murmur ventilatorio pulmonary, or enclosed a rubbing pleural.

If in the development of the pericarditis liquid has accumulated in the sack pericárdico it will be possible to see in:


• The thorax radiography
• Ecocardiograma
• Nuclear magnetic resonance or Scanner of thorax
• Gammagrafía

In these explorations there will be appreciated the increase of size of the heart, the appearance of liquid in the pericardium or even signs of conicidad as a healing and contraction of the pericardium (pericarditis constrictiva).

In the electrocardiogram they will always appear alteraaciones casia and it can conceal the changes that take place in the ECG of a heart attack. For it it is necessary to realize analysis of scoreboards of cardiac infarction in the blood as the CPK and troponina I.

Also they already usually do others analytical to do a diagnosis:


• Serial Hemocultivos
• Finished Hematimetría and VSG
• Protein C - Reactivates
• Puncture of the pericardium, with chemical analysis and cultivation of liquid pericárdico.

TREATMENT

The treatment will depend on the primary cause, but the symptomatic treatment of the pain can be done by anti-inflammatory not steroids (AINEs) like aspirin and ibuprofeno and, in some cases, corticoids can happen.

If there is a lot of piled up liquid a puncture and evacuation is realized (pericardiocentesis) by means of a syringe straight or percutánea directed with an ecógrafo or with open surgery. If it is minor diuretics are used.

The bacterial pericarditis will talk each other with antibiotics and the pericarditis caused by fungi must be treated with antifungoid.

In case of chronic residual injuries that compress the heart it is possible to choose to realize a pericardiectomía (court or partial eradication of the pericardium).

The pericarditis can change from light cases that are solved themselves in days or weeks up to complicated and potentially mortal cases for the liquid accumulation about the heart and the deficient cardiac functioning. If it is attended on time, the result can be very good and the recovery, in most of the persons, capture of 2 weeks to 3 months.

TO SEE ALSO

• Flu
• Lupus
• Been
• Tuberculosis
• Anti-inflammatory not steroids (AINEs)
• Diagnostic methods, analysis and radiology

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