Diagnosis and treatment of acute pericarditis

The article is consulted professionally by Prof. TS.BS. Vo Thanh Nhan – Director of Cardiovascular Center, Share99 Central Park International Health Hub.

Pericarditis is a cardiovascular disease in which the pericardosis is inflamed and may be accompanied by effusion. The pericardic membrane is a thin layer of fiber that wraps around the heart, keeping the heart fixed in the chest and lubricating the heart.

1. Diagnosis of acute pericarditis

1.1. Diagnosis of acute pericarditis with at least 2 of the following symptoms

  • Typical chest pain: after the sternum, intense or slowly, increases with deep inhalation, decreases when lying down or sitting bent forward.
  • There's a pericardic brush.
  • Characteristics on the electrolysic:st segment spreads up spread or PR spreads down.
  • Cardiac ultrasound; new or aggravated pericarditis

1.2. Diagnostic tests for acute pericarditis

  • Electrolysynth

The electrolysym will go through 4 stages. This is a very valuable test for definitive diagnosis, differentive diagnosis and evaluation of the stage of acute pericarditis.

– The initial stage usually appears a few hours after the appearance of the first chest pain. This is a very difficult period to distinguish from the signs of early re-polarity or acute myocardial infarction on the electrocardiologist. Classic stage 1 will include ST markings that differ in the same direction as positive T waves in pre-cardiac trajectories.

– The second stage appears a few days later with the ST section returning to the isosymm, T-wave flattened down.

– Stage three is the inverted T-wave phase.

– Stage four: After a few days to several weeks T waves will be positive again, this is the final stage of the disease.

If acute pericarditis has a pericarditis, patients may show signs of reduced voltage (especially in peripheral trajectory) and signs of voltage er levoids.

  • Cardicardimonary imaging

Large heart imaging is usually only seen in cases of coordinated pericarditis, and this is also not a specific sign that helps diagnose acute pericarditis.

X-ray

Large heart shape is usually only seen in cases of coordinated pericarditis

Blood cultures, sputum implants and gastric juices

It is capable of helping to diagnose a number of complex cases of acute pericarditis such as tuberculosis (after 1 week), sepsis or infectious endocarditis.

  • Blood tests

There is usually leukocyukocyukocyity, increased blood sedity and increased yeast creatine phosphokinase MB.

  • Heart ultrasound

Cardiac ultrasound is usually in place in later stages of acute pericarditis (weeks after the first clinical sign appears) or when hemolysis is present however routine can also be done in all cases for diagnosis of exclusion. Possible signs on ultrasound are ultrasonic voids caused by pericarditis (8 to 15% of acute cases of pericarditis). More rare may show signs of thicker pericardia than normal.

On the other hand, in cases where patients with acute pericarditis have new heart surgery or suspected pericarditis, at this time an ultrasound of the heart becomes quite important, it is necessary to perform several times to assess the progress of acute pericarditis.

Heart ultrasound

Cardiac ultrasound is usually in place in later stages of acute pericarditis
  • Other tests

Cardiac ultrasound through the arye, computer cirlitncation, nuclear resonance can be applied in a few separate cases to further study the pericardi membrane.

  • Differentive diagnosis

Chest pain caused by dissection of the aortic wall, pulmonary infarction, pneumonia or myocardial infarction.

Electrocardigraphy transformations should be distinguished from variations caused by local myocardial anemia. The development of the ST and T-waves allows distinguishing in the vast majority of cases. However, in cases of ST spreading the vagina need to do ultrasound to diagnose the exclusion of myocardial infarction (find regional movement disorders on the cardiac ultrasound).

2. Treatment of acute pericarditis

What is the use of Augmentin?

The vast majority of acute pericarditis cases have no complications, the disease will cure itself and respond well to medical treatment

2.1. General principles in the treatment of acute pericarditis

The vast majority of acute pericarditis cases have no complications, the disease will cure itself and respond well to medical treatment.

The treatment drug is mainly non-steroidalanti-inflammatory drugs .

It is more difficult to treat acute pericarditis with complications of pericarditis or spasmodic pericarditis.

2.2. Medical treatment

Ibuprofen 600 to 800mg orally divided 3 times a day, for 3 weeks or Indomethacin 25 to 50mg orally divided 3 times a day, for 3 weeks.

In cases where patients treated for acute pericarditis who do not respond to nonsteroidal anti-inflammatory or in case of recurrence of pericarditis may use oral prednisone for 3 weeks, intravenous administration with Methylprednisolone may also be used in severe cases. Colchicine 1mg during the day has also been pointed out by several studies to be effective in the treatment of acute pericarditis.

2.3. Treatment of pericardous pericardous effusion through the skin (pericarditis with cardiac compression)

Only applied in cases of acute pericarditis with a lot of effusion, affecting hemolysis or in cases where it is necessary to poke a probe to diagnose the disease. Lumbar puncture with local anesthesia can place conductive circulation in cases of multiple, recurrent epidemics.

2.4. Medical treatment

Opening pericarditis under the sternum usually applies only in cases of acute pericarditis caused by cancer.

Pericardic surgery is often applied in recurrent effusions or pericarditis.

2.5. Notes when treating

If you do not respond to NSAIDs or Aspirin for 1 week (fever, chest pain, new pericarditis, total bad condition) you should think of a cause other than immitis or viral pericarditis.

Symptomatic pericarditis after acute myocardial infarction ,aspirin should be given. NSAIDs should not be used.

Due to non-steroidal anti-inflammatory treatment affecting the gastric mucosa: usually combined inhibition of proton pumps in the following cases: pre-ulcer gastric ulcer, age >65, pre-use of aspirin or corticoids or anti-freezing.

In patients with acute pericarditis in which anti-tingotitis is in place, aspirin should be used at higher doses (700-1000mg/day instead of 100-300mg/day).

In contrast to anti-tingotitis treatment, in patients with acute pericarditis taking anti-freezing drugs increases the risk of pericardial bleeding and interactions that increase the effect of antivitamin K drugs. Therefore, caution and close monitoring should be taken in these patients when combined use is required.

In addition, in order to prevent acute pericarditis effectively, we need to actively build a healthy lifestyle, a scientific diet. Regularly exercise, limit stimulants, especially regular health checkups to promptly detect signs of early acute pericarditis, timely treatment, avoid unfortunate things happening.

For direct advice, please click hotline number or register online HERE. In addition, you can register for remote consultation HERE

SEE MORE:

  • Diagnosis of pericarditis
  • What is low heart disease? Features of the disease
  • The dangers of pericarditis

About: Minh Quynh

b1ffdb54307529964874ff53a5c5de33?s=90&d=identicon&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.

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