Pathology- Pericarditis
Pericarditis is a condition that can be classified as acute. It can be caused by various factors such as systemic lupus erythematosus (SLE), rheumatoid arthritis, scleroderma, renal failure, viral infection, or malignancies. The presence of fibrinous material in the body can be attributed to several factors such as renal failure, myocardial infarction, acute renal failure, radiation, or post-surgical trauma. On the other hand, the occurrence of hemorrhagic conditions might be linked to tuberculosis or malignancy. Or suppurative infections caused by bacteria such as Mycobacterium tuberculosis, Staphylococcus, or Streptococcus pneumoniae. Risk factors: History of acute pericarditis, previous heart surgery, and chest radiation therapy Acute serous pericarditis is characterized by the presence of a protein-rich fluid in the area surrounding the heart, along with an inflammatory response on the surfaces of the tissues. Two Fibrinous refers to the presence of a significant amount of fibrin, a protein, in the area surrounding the pericardium. It may eventually form or arrange into a scar: (3) Suppurative: The presence of pus with a significant inflammatory response on tissue surfaces, which typically leads to the formation of scar tissue; (4) Hemorrhagic: The exudate contains a high amount of fibrin and is accompanied by bleeding in the pericardial space. Constrictive: The heart is surrounded by a fibrous scar, resulting in the loss of the pericardial space. This leads to a decrease in ventricular contraction and venous return, resulting in reduced cardiac output. Presenting Symptoms The patient presents with acute symptoms including chest pain that worsens with inspiration and when in a supine posture. Other notable findings include a friction rub, pulsus paradoxus, distant heart sounds, fever, nonproductive cough, and Kussmaul sign (increased venous pressure with inspiration). Complications may arise, such as tamponade. Laboratory results indicate the presence of widespread inwardly curved ST elevations with PR depression in the majority of electrocardiogram (ECG) leads, and normal levels of CK-MB. Constrictive pericarditis is characterized by diminished heart sounds, Kussmaul sign, presence of S3, and can present with symptoms of right-sided heart failure such as dyspnea, tiredness, and peripheral edema. Management Immediate: Address any known underlying causes: Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended for the treatment of repeated instances, with colchicine being a specific option. A corticosteroid is a type of medication that is used to reduce inflammation and suppress the immune system. Constrictive: Mild increase in urine production: pericardiectomy
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