Pericarditis
Symptoms:
- chest pains
- usually relieved with sitting
- pleuritis type: described as sharp, stabbing
- may radiate to the neck, shoulder, back, or abdomen
- increases with deep breathing
- breathing difficulty, lying down
- the preferred position is upright, standing, or sitting
- splinting of ribs (bending over or holding the chest) with breathing
- difficulty breathing
- dry cough
- swelling of the abdomen (occasionally)
- swelling, overall (occasionally)
- ankle, feet, and leg swelling (occasionally)
- anxiety
- fatigue
- fever
- chills
- sweating
Signs and tests:
When listening to the heart with a stethoscope (auscultation), the health care provider can hear a pericardial rubbing sound and heart sounds may be faint or distant. There may be other signs of fluid in the pericardium (pericardial effusion). If the disorder is severe, there may be crackles in the lungs, decreased breath sounds, or other signs of fluid in the space around the lungs (pleural effusion).
Fluid around the heart may show on: These tests may show scarring and contracture of the pericardium (constrictive pericarditis), or they may show enlargement of the heart from fluid collection in the pericardium.
An ECG may show changes that resemble ischemic changes (caused by insufficient oxygen) but which are usually more widespread. Ischemic changes usually appear on only a few of the 12 leads (views) of a standard ECG, but the changes of pericarditis commonly involve 6 or more leads (two or three standard leads and leads V2 through V6).
Cardiac enzymes (LDH and CPK tests) may be used to rule out acute MI (heart attack) as the cause of chest pain; however, mild elevations of cardiac enzymes can also occur in pericarditis. (Heart attack is rare in children.)
Other tests may include:
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