This condition is caused by an inflammatory process that leads to symptoms such as chest pain, ECG alterations, and, in certain cases, an effusion of the pericardium, as well as changes in the electrocardiogram (ECG). At least two of these three traits must be present to make a diagnosis.
Acute pericarditis is the most prevalent kind of acute pericarditis, accounting for around 90% of cases. Infection, renal failure, myocardial infarction (MI), post-cardiac damage syndrome, cancer, radiation, and trauma are among the other common causes of ventricular fibrillation. Later, we’ll go into greater detail about these issues.
Symptoms and Signs
● Pain radiating to the neck, shoulders, or back is common in patients with acute pericarditis, which is characterized by a sudden onset of severe retrosternal chest pain.
● Changes in posture are common when the pain worsens in the supine position and when inspiration occurs, whereas sitting upright and leaning forward improves the condition.
● High-pitched squeak, reminiscent of the sound of a brand-new saddle’s leather creaking under your feet.
● Inflammation of the pericardium is thought to create fibrinous deposits in the pericardium that can be mono-, bi-, or tri-phasic (corresponding to atrial systole, ventricular systole, and early ventricular diastole, respectively).
● When the patient is bending forward, listen for it at the left lower sternal boundary during inspiration. In the event of effusion and/or an approaching cardiac tamponade, the rub may go away.
Diagnosis
Clinical examination, history, physical exam, electrocardiogram, and echocardiogram are the only ways to diagnose acute pericarditis. CT and MRI may be utilized in some circumstances to examine the pericardium.
Treatment
Acute pericarditis is usually a simple and self-limiting condition that can be managed in the outpatient setting. An advanced imaging modality or hospitalization may be indicated if there is clinical suspicion of an extensive effusion, hemodynamic instability (including severe pain or other symptoms), significant other health problems, or any other indications or symptoms that the patient is in unstable health. In addition to fevers above 38°C, a subacute onset, failure to respond to anti-inflammatory therapy, myopericarditis, immunosuppression, trauma, or concurrent treatment with oral anticoagulant therapy, all point to a more complicated course.
Medical Management
The goal of treatment for acute idiopathic and viral pericarditis is to reduce discomfort and inflammation. Therapy is focused on treating the underlying disease in cases of acute pericarditis with various causes. Colchicine and nonsteroidal anti-inflammatory medications (NSAIDs) should be used in combination.
Colchicine 0.6 mg twice a day (0.6 mg once daily if you weigh less than 70 kg) and ibuprofen 600 mg or indomethacin 50 mg every 8 hours for one to two weeks, followed by a progressive taper, is our normal suggestion.
Aspirin (650–1,000 mg three times daily) should be taken instead of non-aspirin NSAIDs in the early period (7–10 days) following MI (may predispose to heart rupture). A proton pump inhibitor is advised for patients at high risk of gastrointestinal toxicity because of the possibility of gastrointestinal toxicity.
Cardiologist at Doral Health and Wellness
Experts in cardiology at the Doral Health and Wellness Clinic treat cardiac defects, coronary artery disease, heart failure, and valvular diseases such as atherosclerosis and aortic aneurysms. Some of the subspecialties of cardiology include cardiac electrophysiology, echocardiography, interventional cardiology, and nuclear cardiology. Please give us a call at the number 347-868-1012.
