Pericarditis x ray: Difference between revisions
Homa Najafi (talk | contribs) No edit summary |
Homa Najafi (talk | contribs) |
||
| Line 33: | Line 33: | ||
[[Image:Pericardial calcification.jpg|left|thumb|350px|Pericardial calcifications in [[constrictive pericarditis]]]] | [[Image:Pericardial calcification.jpg|left|thumb|350px|Pericardial calcifications in [[constrictive pericarditis]]]] | ||
<br clear="left"/> | <br clear="left"/> | ||
==2015 ESC Guidelines on the Diagnosis and Treatment of Pericarditis (DO NOT EDIT)<ref name="AdlerCharron2015">{{cite journal|last1=Adler|first1=Yehuda|last2=Charron|first2=Philippe|last3=Imazio|first3=Massimo|last4=Badano|first4=Luigi|last5=Barón-Esquivias|first5=Gonzalo|last6=Bogaert|first6=Jan|last7=Brucato|first7=Antonio|last8=Gueret|first8=Pascal|last9=Klingel|first9=Karin|last10=Lionis|first10=Christos|last11=Maisch|first11=Bernhard|last12=Mayosi|first12=Bongani|last13=Pavie|first13=Alain|last14=Ristić|first14=Arsen D.|last15=Sabaté Tenas|first15=Manel|last16=Seferovic|first16=Petar|last17=Swedberg|first17=Karl|last18=Tomkowski|first18=Witold|title=2015 ESC Guidelines for the diagnosis and management of pericardial diseases|journal=European Heart Journal|volume=36|issue=42|year=2015|pages=2921–2964|issn=0195-668X|doi=10.1093/eurheartj/ehv318}}</ref>== | |||
===Recommendations for the general diagnostic work-up of pericardial diseases=== | |||
{|class="wikitable" | |||
|- | |||
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| bgcolor="LightGreen"|<nowiki></nowiki>'''1.''' In all cases of suspected [[pericardial disease]] a first [[diagnostic]] evaluation is recommended with: | |||
– [[auscultation]] | |||
– [[ECG]] | |||
– [[transthoracic echocardiography]] | |||
– [[chest X-ray]] | |||
– routine [[blood tests]], including markers of [[inflammation]] (i.e., [[CRP]] and/or [[ESR]]), white [[blood cell count]] with differential count, [[renal function]] and [[Liver function tests|liver tests]] and [[myocardial]] [[Lesions|lesion]] [[Test|tests]] ([[CK]], [[Troponin|troponins]]). | |||
'''2.''' [[CT]] and/or [[CMR]] are recommended as [[second]]-level [[testing]] for [[diagnostic]] workup in pericarditis. | |||
'''3.''' [[Pericardiocentesis]] or [[Drain (surgery)|surgical drainage]] are [[Indication (medicine)|indicated]] for [[cardiac tamponade]] or suspected [[bacterial]] and [[neoplastic pericarditis]]. | |||
'''4.''' Further testing is [[Indication (medicine)|indicated]] in high-risk [[patients]] (defined as above) according to the [[clinical]] [[conditions]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'' | |||
''<nowiki/>'' | |||
|} | |||
===Recommendations for diagnosis of acute pericarditis=== | |||
{|class="wikitable" | |||
|- | |||
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| bgcolor="LightGreen"|<nowiki></nowiki>'''1.''' [[The electrocardiogram|ECG]] is recommended in all [[patients]] with suspected [[acute pericarditis]]. | |||
'''2.''' [[Transthoracic echocardiography]] is recommended in all [[patients]] with suspected [[acute pericarditis]]. | |||
'''3.''' [[Chest X-rays|Chest X-ray]] is recommended in all [[patients]] with suspected [[acute pericarditis]]. | |||
'''4.''' Assessment of markers of [[inflammation]] (i.e. [[C-reactive protein|CRP]]) and [[myocardial injury]] (i.e. [[CK]], [[troponin]]) is recommended in [[patients]] with suspected [[acute pericarditis]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'' | |||
''<nowiki/>'' | |||
|} | |||
===Recommendations for the diagnosis of constrictive pericarditis=== | |||
{|class="wikitable" | |||
|- | |||
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| bgcolor="LightGreen"|<nowiki></nowiki>'''1.''' [[Transthoracic echocardiography]] is recommended in all [[patients]] with suspected [[constrictive pericarditis]]. | |||
'''2.''' [[Chest X-ray]] ([[frontal]] and [[lateral]] views)with adequate technical characteristics is recommended in all [[patients]] with suspected [[constrictive pericarditis]]. | |||
'''3.''' [[Computed tomography|CT]] and/or [[Cardiovascular magnetic resonance imaging (CMR)|CMR]] are [[Indication (medicine)|indicated]] as second-level [[imaging]] techniques to assess [[Calcification|calcifications]] ([[Computed tomography|CT]]), [[pericardial]] thickness, [[Degree (angle)|degree]] and [[extension]] of [[pericardial]] involvement. | |||
'''4.''' [[Cardiac catheterization]] is [[Indication (medicine)|indicated]] when [[Non-invasive (medical)|non-invasive]] [[diagnostic]] methods do not provide a definite [[diagnosis]] of constriction. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'' | |||
''<nowiki/>'' | |||
|} | |||
==References== | ==References== | ||
Revision as of 01:27, 18 December 2019
|
Pericarditis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Surgery |
|
Case Studies |
|
Pericarditis x ray On the Web |
|
American Roentgen Ray Society Images of Pericarditis x ray |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]
Overview
A flask-shaped, enlarged cardiac silhouette will be observed on chest x-ray in pericarditis complicated with pericardial effusion or tamponade. A mass may also be seen when malignancy is the cause. Calcification of pericardium may be noted in constrictive pericarditis.
Uncomplicated Pericarditis
In uncomplicated pericarditis, in the absence of a pericardial effusion or cardiac tamponade, the heart will not be enlarged on chest x ray.
Complicated Pericarditis
A flask-shaped, enlarged cardiac silhouette will be observed on chest X ray in the setting of pericardial effusion or cardiac tamponade.
Chest X Ray Examples
Images shown below are courtesy of RadsWiki
Pericardial Masses
Pericardial Calcification
2015 ESC Guidelines on the Diagnosis and Treatment of Pericarditis (DO NOT EDIT)[1]
Recommendations for the general diagnostic work-up of pericardial diseases
| Class I |
| 1. In all cases of suspected pericardial disease a first diagnostic evaluation is recommended with:
– ECG – transthoracic echocardiography – routine blood tests, including markers of inflammation (i.e., CRP and/or ESR), white blood cell count with differential count, renal function and liver tests and myocardial lesion tests (CK, troponins). 2. CT and/or CMR are recommended as second-level testing for diagnostic workup in pericarditis. 3. Pericardiocentesis or surgical drainage are indicated for cardiac tamponade or suspected bacterial and neoplastic pericarditis. 4. Further testing is indicated in high-risk patients (defined as above) according to the clinical conditions. (Level of Evidence: C)
|
Recommendations for diagnosis of acute pericarditis
| Class I |
| 1. ECG is recommended in all patients with suspected acute pericarditis.
2. Transthoracic echocardiography is recommended in all patients with suspected acute pericarditis. 3. Chest X-ray is recommended in all patients with suspected acute pericarditis. 4. Assessment of markers of inflammation (i.e. CRP) and myocardial injury (i.e. CK, troponin) is recommended in patients with suspected acute pericarditis. (Level of Evidence: C)
|
Recommendations for the diagnosis of constrictive pericarditis
| Class I |
| 1. Transthoracic echocardiography is recommended in all patients with suspected constrictive pericarditis.
2. Chest X-ray (frontal and lateral views)with adequate technical characteristics is recommended in all patients with suspected constrictive pericarditis. 3. CT and/or CMR are indicated as second-level imaging techniques to assess calcifications (CT), pericardial thickness, degree and extension of pericardial involvement. 4. Cardiac catheterization is indicated when non-invasive diagnostic methods do not provide a definite diagnosis of constriction. (Level of Evidence: C)
|
References
- ↑ Adler, Yehuda; Charron, Philippe; Imazio, Massimo; Badano, Luigi; Barón-Esquivias, Gonzalo; Bogaert, Jan; Brucato, Antonio; Gueret, Pascal; Klingel, Karin; Lionis, Christos; Maisch, Bernhard; Mayosi, Bongani; Pavie, Alain; Ristić, Arsen D.; Sabaté Tenas, Manel; Seferovic, Petar; Swedberg, Karl; Tomkowski, Witold (2015). "2015 ESC Guidelines for the diagnosis and management of pericardial diseases". European Heart Journal. 36 (42): 2921–2964. doi:10.1093/eurheartj/ehv318. ISSN 0195-668X.