Pericarditis: diagnosis and treatment

Diagnosis of pericarditis

The diagnosis of pericarditis results from the complaints and the examination results. Typical when listening is a friction noise, but often disappears as soon as an effusion forms. Imaging diagnostics include, in particular, the chest X-ray, electrocardiogram (ECG) and cardiac ultrasound. Ultrasound has the advantage that the fluid accumulation in the pericardium and its effects on cardiac function can be directly displayed.

For the cause research one can take fluid from the effusion and examine which cells there occur: inflammatory cells, protein, blood components or degenerated cells of cancerous tumors.

Treatment of pericarditis

General measures are used to alleviate the symptoms and remedy the sequelae of inflammation such as pericardial effusion. If a cause is known, it is treated. For example, the rheumatic fever is treated with antibiotics and cortisone and in immune diseases, the body's defense is suppressed. Renal impairment, hypothyroidism or cancer are also addressed by special measures.

For chest pain, analgesics can be given. In case of severe pericardial effusion, the excess fluid in the pericardium must be drained via a catheter inserted into the pericardium via a long needle from the front below the costal arch. In most cases of acute pericarditis, the inflammatory process heals without consequences after one or more fluid discharges.

Only in the rare case of chronically recurring pericardial effusions does the pericardium have to be surgically "fenestrated" to allow the flammable fluid to drain on its own. With the rare armor heart the Perikardvernarbungen must be removed by the heart surgeon.

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