Dry and exudative pericarditis: symptoms, diagnosis and treatment

Pericarditis is an acute or chronic inflammation of the pericardium (the outer serosa of the heart). In the inflammatory process, the myocardium is often involved. Mostly men suffer from this ailment. Pericarditis is possible in children and adolescents.

As a rule, pericarditis is a secondary disease that complicates the course of various diseases. The causes of its development can be acute infections, autoimmune (rheumatism and other collagenoses), metabolic diseases, myocardial infarction, chest trauma, aortic aneurysm, condition after surgical intervention on the heart.

Acute pericarditis and chronic are distinguished along the course. Clinically, pericarditis can be dry, called still fibrinous, and exudative - effusive.

Pericarditis: symptoms of the disease in a clinical examination

In acute pericarditis is characterized by chest pain, radiating to the left side of the thorax and the left arm. This pain is quite intense, prolonged, intensified at the height of inspiration, during coughing, in a supine position. To reduce pain, patients often take the forced position of the body: they sit, leaning forward. This position is called the pose of a praying Bedouin. The intensity of pain increases depending on the position of the body, and when performing movements. In some cases, pericarditis pain can be blunt, aching.

Accompany any pericarditis symptoms of intoxication - fever, joint and muscle pain, general malaise, palpitation, headache. The accumulation of exudate effusion in the cavity of the cardiac sac, lined with the pericardium, is accompanied by the appearance of dyspnea, which decreases in the sitting position. With shortness of breath, there may be a dry, unproductive cough.

The accumulation of a large volume of fluid in the cavity of the cardiac sac leads to the development of the syndrome of cardiac tamponade, which is manifested by symptoms of venous stasis. At the patient at inspection it is possible to define an overflow of veins of a neck, augmentation of a liver, occurrence of edemas and an ascites (a free liquid in an abdominal cavity).

If dry pericarditis develops, there are no symptoms of changing the boundaries of the heart. If the volume of exudate exceeds 500 ml, you can determine the displacement of the boundaries of cardiac dullness in both directions. With dry pericardial heart tones auscultatory do not change. With the development of exudative pericarditis, the volume of cardiac tones drops sharply, tachycardia is determined.

The specific sign of dry pericarditis, determined during auscultation, is the pericardial friction noise. This noise can be heard on a limited area of the chest, to the left at the edge of the sternum. Noise can be increased by pressing the phonendoscope on the chest wall. He is heard during systole and diastole, quickly disappears.

Dry and exudative pericarditis - symptoms in additional studies

For the diagnosis of the disease, a general blood test, ECG, echocardiography, chest X-ray examination are prescribed . In the general analysis of blood, signs of inflammation are determined. On ECG with exudative pericarditis, a decrease in the height of the teeth is detected, rhythm disturbances may appear, with dry pericardial the position of the ST segment above the isoline is determined. Changes on the roentgenogram are determined with the accumulation of 200 and more ml of exudate. When echocardioscopy is determined by the localization of the process and the amount of exudate. With a diagnostic purpose, a pericardial cavity puncture is performed, followed by examination of the resulting fluid.

Acute dry pericarditis has a benign course. Exudative pericarditis often occurs subacute or becomes chronic.

In the treatment of pericarditis, non-steroidal anti-inflammatory drugs, corticosteroids are used. With exudative pericarditis prescribed diuretics, puncture of the pericardial cavity with a therapeutic purpose. The appointment of antibacterial therapy, a diet with salt and liquid restriction is shown.