First, through its mechanical function, the pericardium promotes cardiac efficiency by limiting acute cardiac dilation, maintaining ventricular compliance with preservation of the Starling curve, and distributing hydrostatic forces. Acute pericarditis during 5-fluorouracil, docetaxel and cisplatin therapy. It is usually a benign condition that does not cause serious long term adverse effects on the heart. Uremic pericarditis has a prevalence of 6-10% in patients with acute or chronic renal failure, and it continues to be associated with significant morbidity and occasional mortality.Renal failure accounts for approximately 12% of cases of pericarditis.

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Pericardial effusions can lead to significant hemodynamic complications during routine dialysis. Diffuse T wave inversion. American College of Cardiology. Myocarditis is an inflammatory disease of the middle layer of the heart muscle that encloses the heart. Hammer MM, Raptis CA, Javidan-Nejad C, Bhalla S. Accuracy of computed tomography findings in acute pericarditis. 2002 Serum titers for suspected infectious etiologies and testing for tuberculosis exposure (ie, PPD or interferon-gamma release assays) may be helpful.Treatment for specific causes of pericarditis is directed according to the underlying cause. This procedure is used for constrictive pericarditis, effusive pericarditis, or recurrent pericarditis, steroid dependence, and/or intolerance to other medical management.Patients with effusions larger than 250 mL, effusions in which size increases despite intensive dialysis for 10-14 days, or effusions with evidence of tamponade are candidates for pericardiocentesis.Pericardial window placement is used for effusive pericarditis therapy.
Hemorrhagic pericarditis is common after cardiac surgery or trauma and may cause tamponade. Blank N, Lorenz HM. Since that classic description, this common complication of chronic renal failure has evolved from an ominous event heralding the terminal stages of disease to an event that, with early management, is likely to have a good outcome. With inflammation of the adjacent pericardium, ECG features of pericarditis can also been seen (= myopericarditis). Immunosuppression facilitates this condition. The other type is dialysis-associated pericarditis, which occurs in patients who are already receiving dialysis. In: Braunwald E, ed. T wave is diffused or inversed. The pericardium also creates a closed chamber with subatmospheric pressure that aids atrial filling and lowers transmural cardiac pressures. H&E stain, medium power magnification showing a rheumatoid nodule in rheumatoid pericarditis, composed of histiocytes and scattered multinucleated giant cells (lower right) surrounding necroinflammatory debris (upper left). Untreated, caseous pericarditis is the most common antecedent to chronic constrictive pericarditis of a fibrocalcific nature.Adhesive mediastinopericarditis is a reaction that usually follows suppurative or caseous pericarditis, cardiac surgery, or irradiation. Often, stage 1 electrocardiographic (ECG) findings are absent (see The following conditions may also cause acute pericarditis:Vasculitis (eg, giant cell arteritis, polyarteritis)Richard Bright described uremic pericarditis in 1836. Eckart RE, Love SS, Atwood JE, et al, for the Department of Defense Smallpox Vaccination Clinical Evaluation Team.

However, although this condition is more common in adults than in children, adolescents are more commonly affected than young adults. In one study, 56% developed pericardial effusions early after cardiac surgery, without correlation to pericarditis or tamponade. In tuberculous pericarditis, fever, night sweats, and weight loss are commonly noted (80%).Specific causes of pericarditis include the following:Infectious conditions, such as viral, bacterial, and tuberculous infectionsInflammatory disorders, such as RA, SLE, scleroderma, and rheumatic feverMetabolic disorders, such as renal failure and hypothyroidismCardiovascular disorders, such as acute MI, Dressler syndrome, and aortic dissectionMiscellaneous causes, such as iatrogenic, neoplasms, drugs, irradiation, sarcoidosis, cardiovascular procedures, and traumaInitial evaluation includes a clinical history and physical examination, ECG, echocardiography, chest radiography, and lab studies.ECG can be diagnostic in acute pericarditis and typically shows diffuse ST elevation. Perforation, as well as direct catheter infusion of fluids, can cause tamponade. In mild cases, it may not show any deviation of waves.


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