Pericarditis

Pericarditis is inflammation of the pericardium.

Pathology

Fibrinous pericarditis is an exudative inflammation. The pericardium is infiltrated by the fibrinous exudate. This consists in fibrin strands and leukocytes. Fibrin describes an eosinophilic (pink) network, amorphous. Leukocytes (mainly, neutrophils) are found within the fibrin deposits and intrapericardic. Vascular congestion is also present. The myocardium has no changes. Photo at: Atlas of Pathology

Signs and Symptoms

Chest pain, radiating to the back and relieved by sitting up forward, is the classical presentation. Generalised ST-elevations on ECG may be recorded. Other symptoms may include dry cough, fever, fatigue and anxiety.

Causes

• Coxsackie viral infection
• Rheumatismal
• Tuberculosis
• Uremia
• Malignancy (paraneoplastic phenomenon)
• lupus erythematosus
• idiopathic

Treatment

The treatment in viral or idiopathic pericarditis is with non-steroidal anti-inflammatory drugs. Severe cases may require:

• pericardiocentesis
• antibiotics
• steroids
• surgery