Pericardial diease Pericarditis
Pericardial diease Pericarditis
Introduction.The patterns of pericardial disease have changed over the last 20-30 years,with the once common tuberculous pericarditis becoming a rare entity.Uremic pericarditis formerly one of the most dreaded complications of renal failure,is now managed with relative ease. Pericarditis can be acute and self-limited,subacute, or chronic.Chronic forms of pericarditis often result in cardiac constriction.A variety of agents cause pericarditis.Pericarditis is likely to lead to effusion, which may be minor or large enough to interfere with ventricular filling during diastole (tamponade). Chronic forms of pericarditis often are associated with fibrosis,a condition that can also impede diastolic,ventricular filling
• Introduction. The patterns of pericardial disease have changed over the last 20-30 years, with the once common tuberculous pericarditis becoming a rare entity. Uremic pericarditis , formerly one of the most dreaded complications of renal failure, is now managed with relative ease. Pericarditis can be acute and self-limited, subacute, or chronic. Chronic forms of pericarditis often result in cardiac constriction. A variety of agents cause pericarditis. Pericarditis is likely to lead to effusion, which may be minor or large enough to interfere with ventricular filling during diastole (tamponade). Chronic forms of pericarditis often are associated with fibrosis, a condition that can also impede diastolic, ventricular filling
Table 1.Causes of acute pericarditis Malignant tumor Idiopathic pericarditis Uremia Bacteria infection Anticoagulant therapy Dissecting aortic aneurysm Diagnostic procedures Connective tissue disease Postpericardiotomy syndrome Trauma Tuberculosis Radiation Drugs inducing lupuslike syndrome Chylopericardium Postmyocardial infraction syndrome Fungal infections AlDS-related pericarditis
• Table 1. Causes of acute pericarditis • Malignant tumor • Idiopathic pericarditis • Uremia • Bacteria infection • Anticoagulant therapy • Dissecting aortic aneurysm • Diagnostic procedures • Connective tissue disease • Postpericardiotomy syndrome • Trauma • Tuberculosis Radiation • Drugs inducing lupuslike syndrome • Chylopericardium • Postmyocardial infraction syndrome Fungal infections • AIDS-related pericarditis
Pathology 。The histopathology of the acute pericarditis is dependent on the underlying etiology.The majority of cases are manifest by hyperemia and increased microvascularity, polymorpholeukocyte accumulation and fibrin deposition. Adhesions can form between the layers of the pericardium,and between pericardium and adjacent structure such as pleura and mediastinum
Pathology • The histopathology of the acute pericarditis is dependent on the underlying etiology. The majority of cases are manifest by hyperemia and increased microvascularity, polymorpholeukocyte accumulation and fibrin deposition. Adhesions can form between the layers of the pericardium, and between pericardium and adjacent structure such as pleura and mediastinum
● History.Much of the historical information obtain from patients with pericarditis varies according to the underlying medical condition.Thus,rheumatoid pericarditis usually accompanies severe rheumatoid arthritis,while radiation pericarditis follows large doses of mediastinal radiation, ordinarily administerd for control of neoplasm.Systemic symptoms may occur,including fever,sweats,chills. weakness,malaise,weight loss,anxiety,and depression.The pain of pericarditis is characteristic: It is almost always precordial in position,sharp and severe,and increasing in severity with deep inspiration or recumbency.Occasionally,pain is felt only when patient lie on the left side and make a maximum inspiratory effort.The pain not infrequently radiates to the neck or left arm and shoulder. Dyspnea usually is seen only in individuals with cardiac tamponade or constriction.Palpitations are noted commonly.These are caused by atrial arrhythmias,which often accompany pericarditis
• History. Much of the historical information obtain from patients with pericarditis varies according to the underlying medical condition. Thus, rheumatoid pericarditis usually accompanies severe rheumatoid arthritis, while radiation pericarditis follows large doses of mediastinal radiation, ordinarily administerd for control of neoplasm. Systemic symptoms may occur, including fever, sweats, chills, weakness, malaise, weight loss, anxiety, and depression. The pain of pericarditis is characteristic: It is almost always precordial in position, sharp and severe, and increasing in severity with deep inspiration or recumbency. Occasionally, pain is felt only when patient lie on the left side and make a maximum inspiratory effort. The pain not infrequently radiates to the neck or left arm and shoulder. Dyspnea usually is seen only in individuals with cardiac tamponade or constriction. Palpitations are noted commonly. These are caused by atrial arrhythmias, which often accompany pericarditis