Pericardis

Short characteristic of a disease

Острый перикардит Pericardis – an inflammation of a pericardiac bag. There is an acute pericardis and a chronic, and also dry and exudative pericardis.

The dry acute pericardis – an independent disease which course is good-quality and comes to an end through one, two months and usually without complications.

The exudative pericardis most often proceeds in a subacute and chronic stage, the disease of accumulation of liquid in a pericardium cavity is followed.

Reasons of emergence of a disease

The pericardis arises because of the infections caused by bacteria, tubercular mycobacteria, rickettsiae, mushrooms, viruses, the elementary because of a pseudorheumatism, rheumatism, a heart attack, injuries (including beam, postoperative), tumors, uraemia, a system lupus erythematosus, because of a lack of vitamins C, B1.

Statistically most often the disease arises against the background of autoimmune diseases, an allergy.

Pericardis symptoms

Symptoms of a pericardis depend on a stage of a disease, character of the liquid which is contained in a pericardium, its quantity, the speed of its accumulation.

At an acute form of a disease the patient complains of heartaches which are felt more near a top of heart or in the bottom of a breast. Pains can be given to the left hand, a neck, a left shoulder-blade, epigastric area, on character they aching, stupid and strong. These symptoms of a pericardis remind a clinical picture of a heart attack or pleurisy, the patient complains of weight, discomfort to heart. Such cardiac pains – the main symptom of a dry pericardis.

When there is an exudate (liquid), its bystry accumulation in a pericardium causes an asthma. Especially an asthma when the patient accepts horizontal position amplifies and it is followed by dry cough. If the phrenic nerve is irritated, vomiting is added to the specified symptoms of a pericardis.

The exudative pericardis is followed by reduction, is frequent disappearance of an apical beat of heart – it is caused by a large amount of liquid in a pericardium. There is a predisposition to increase in absolute cordial dullness (the site of a thorax on which at percussion (percussion) determine area of heart by a special sound). Swelling of veins on a neck is noticed.

At an exudative pericardis cordial tops are sharply muffled, sinus tachycardia develops. At emergence of an exudate it is possible to hear a pericardial rub.

Diagnosis of a disease

The acute pericardis is determined for a start by the general symptoms: temperature is subfebrile, a leukocytosis with shift to the left, the raised SOE. Conduct X-ray inspection on which the exudate is found, and do an ECG.

Treatment of a pericardis

Начинают лечение перикардита в острой стадии с введения внутривенно 2мл раствора анальгина Begin treatment of a pericardis in an acute stage with introduction intravenously of 2 ml of solution of analginum of 50% or 2 ml of solution of Promedolum of 2% (under skin or intravenously), or 1-2ml solution of pantopon of 2%. To the patient appoint also to inhale mix of oxygen and nitrogen. The good result at treatment of a pericardis is yielded by anti-inflammatory drugs – salicylates, corticosteroids, etc.

At a stage of first-aid treatment to the patient there can sometimes be a need for carrying out a pericardiocentesis and removal 150-200ml liquids. If in a cavity there was a pus, the patient needs to enter penicillin.

Treatment of a pericardis cardiac glycosides is considered in this case inefficient.

Prevention of a disease

Prevention of a pericardis represents the prevention of diseases which can provoke it: rheumatism, pneumonia, heart attack, tuberculosis, pseudorheumatism, histoplasmosis, amebiasis, cancer of a lung or breast, scleroderma, melanoma, sarcoidosis, lymphoma, amyloidosis, leukemia, coccidioidosis, Wegener's granulomatosis. If these diseases nevertheless arise, it is necessary to take care of their timely and adequate treatment.

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