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In this case, the patient is experiencing post-myocardial infarction pericarditis (PIP), which is characterized by chest pain, low-grade fever, and specific findings on physical examination and electrocardiogram. Aspirin is the drug of choice for PIP and is usually already prescribed for secondary prevention following a myocardial infarction.
Conversely, patients with unexplained new onset cardiomegaly should always be worked up for acute pericarditis. [citation needed] An echocardiogram is typically normal in acute pericarditis but can reveal pericardial effusion, the presence of which supports the diagnosis, although its absence does not exclude the diagnosis. [citation needed]
Purulent Pericarditis; Echocardiogram showing pericardial effusion with signs of cardiac tamponade: Specialty: Cardiology: Symptoms: substernal chest pain (exacerbated supine and with breathing deeply), dyspnea, fever, rigors/chills, and cardiorespiratory signs (i.e., tachycardia, friction rub, pulsus paradoxus, pericardial effusion, cardiac tamponade, pleural effusion)
Constrictive pericarditis is a condition characterized by a thickened, fibrotic pericardium, limiting the heart's ability to function normally. [1] In many cases, the condition continues to be difficult to diagnose and therefore benefits from a good understanding of the underlying cause.
Dressler syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of fever, pleuritic pain, pericarditis and/or pericardial effusion.
Uremic pericarditis is associated with azotemia, and occurs in about 6-10% of kidney failure patients. BUN is normally >60 mg/dL (normal is 7–20 mg/dL). However, the degree of pericarditis does not correlate with the degree of serum BUN or creatinine elevation. The pathogenesis is poorly understood. [2]
During medical doctor examination, a pericardial friction rub can be auscultated indicating pericarditis. Auscultation of the lungs can show crackles indicating pulmonary infiltration, and there can be retrosternal/pleuritic chest pain worse on inspiration (breathing in). Patient can also depict sweating (diaphoresis) and agitation or anxiety.
In medicine, Friedreich's sign is the exaggerated drop in diastolic central venous pressure seen in constrictive pericarditis (particularly with a stiff calcified pericardium) and manifested as abrupt collapse of the neck veins or marked descent of the central venous pressure waveform. The normal jugular venous waveform contains two descents, x ...