EDUCATION IN HEART

General cardiology

Practical aspects of the management of pericardial disease

Bernhard Maisch, Arsen D Risti

Department of Internal Medicine-Cardiology, Faculty of Medicine, Philipps University, Marburg, Germany

Correspondence to:
Correspondence to:
Professor Bernhard Maisch, Faculty of Medicine, Department of Internal Medicine-Cardiology, Philipps University, Marburg, Baldingerstrasse 1, D-35033 Marburg, Germany;
BerMaisch@aol.com

Keywords: pericarditis; pericardiectomy; pericardiocentesis; pericardioscopy; pericardiotomy

The first 150 words of the full text of this article appear below.

The aetiology based classification of pericardial disease comprises: infectious pericarditis; pericarditis in systemic autoimmune diseases; type 2 (auto)immune pericarditis; metabolic disorders; trauma; tumours; pericardial cysts; and congenital defects.¹ This classification has major therapeutic consequences that will be elaborated upon in this article, with the focus on practical management of pericardial syndromes and specific underlying diseases.

DIAGNOSTIC ASPECTS

The diagnosis of acute pericarditis relies on clinical findings, ECG changes, and echocardiography (table 1).^2,3 Chronic pericardial inflammation includes effusive, adhesive, and constrictive forms, lasting three months or more. Recurrent pericarditis may be intermittent (symptom-free interval without treatment) or incessant (discontinuation of anti-inflammatory treatment always ensures a relapse).

View this table: [in this window] [in a new window]   Table 1 Diagnostic pathway and sequence of performance in acute pericarditis.2,3

 

Pericardial effusion occurs as transudate (hydropericardium), exudate, pyopericardium or haemopericardium, or a mixture of these. Large effusions generally indicate more serious disease and are common with neoplasia, tuberculosis, hypercholesterolaemia, uraemic pericarditis, myxoedema, and parasitoses.^2,4 Patients . . . [Full text of this article]

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