Pericarditis


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pericarditis

[‚per·ə‚kär′dīd·əs]
(medicine)
Inflammation of the pericardium.

Pericarditis

 

inflammation of the pericardium.

Among the causative agents of infectious pericarditis in man are cocci, viruses, and Mycobacterium tuberculosis. Sensitization of the pericardium by the products of tissue protein degradation and by bacterial toxins plays a role in the development of infectious pericarditis. Such an allergic mechanism may also be an independent pathogenetic factor. Rheumatic pericarditis is the commonest form.

Among the causes of noninfectious pericarditis are uremia, myocardial infarction, trauma, and postoperative factors. There is also a benign pericarditis of unknown etiology (idiopathic pericarditis). Fibrinous pericarditis, in which a dry film (fibrin) is deposited on the layers of the pericardium, occurs in tuberculosis, uremia, and myocardial infarction. Pericarditis with effusion, in which the pericardial cavity is filled with an exudate, may be serous or serofibrinous (tuberculous, rheumatic, idiopathic pericarditis), hemorrhagic (tuberculous pericarditis and various tumors), or purulent or pyogenic, which may result from a pulmonary abscess.

Symptoms of pericarditis include malaise, fever, chills, and sweating; the blood exhibits changes. In dry pericarditis, additional symptoms are pain in the heart and a pericardial friction rub. Additional symptoms in pericarditis with effusion are poor general condition, palpitation, dyspnea, distention of the veins of the neck, bulging of the heart, and widening of the cardiac silhouette owing to the exudate. The outcome of pericarditis may be complete resorption of the exudate or formation of adhesions and fusion of the layers of the pericardium.

Treatment, depending on the cause of pericarditis, may be antirheumatic, antitubercular, and so on. Antibiotics, antiallergy and anti-inflammatory drugs, and symptomatic treatment are also used. If necessary, the exudate is removed by puncture or surgery.

REFERENCES

Jonaš, V. Chastnaia kardiologiia, 3rd ed. Prague, 1963. (Translated from Czech.)
Miasnikov, A. L. Vnutrennie bolezni. Moscow, 1967.

A. Z. CHERNOV

Pericarditis in animals, often due to injury, occurs in cattle and, less often, in other ruminants. It is caused by metallic and other sharp objects entering the rumen with food, perforating the wall of the reticulum and diaphragm, and traumatizing the pericardium, causing inflammation and accumulation of exudate. Initial symptoms include tenderness in the heart region, groaning, rejection of food, and slackening of rumination. Later symptoms include distension of the neck veins, edema of the dewlap and intermaxillary space, widening of the cardiac silhouette, a pericardial friction rub and clapotement (splashing sound), and intermittent fever. Since the prognosis is unfavorable, the sick animals are killed, and their meat is used only on the instructions of a veterinarian. Prevention involves keeping pastures, food storage areas, barnyards, and cattle passes free of metallic objects and removing metallic objects from free-flowing feed by magnets.

REFERENCE

Vnutrennie nezaraznye bolezni sel’skokhoziaistvennykh zhivotnykh, 4th ed. [Edited by I. G. Sharabrin.] Moscow, 1972.

N. M. PREOBRAZHENSKII

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Based on clinical, ECG, blood, and TEE findings, acute myocardial infarction was excluded and final diagnosis was epistenocardiac pericarditis. The treatment with antiplatelets (salicylic acid), Ca-channel antagonists (verapamil), and digoxin was successful and the patient had no symptoms; physical examination was normal, ECG showed the following: sinus rhythm (HR of 60/min) and negative T-wave from leads V2 to V6; chest X-ray corresponded with condition after right pneumonectomy (Figure 2).