Tuberculous pericarditis differential diagnosis: Difference between revisions

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| colspan="6" rowspan="1"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Clinical manifestations'''
| colspan="6" rowspan="1"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Clinical manifestations'''
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! colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Para-clinical findings
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! colspan="6" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
| colspan="1" rowspan="4"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Gold standard'''
| colspan="1" rowspan="4"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Gold standard'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;|Additional findings
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;|Additional findings
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| rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''History'''
| rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''History'''
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Symptoms'''
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Symptoms'''
! colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
! colspan="5" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
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|-
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab Findings
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging
! colspan="4" |Imaging
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Histopathology
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Histopathology
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|-  
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! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|JVP
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|JVP
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Heart/Lung sounds
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Heart/Lung sounds
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Hepatosplenomegaly
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Hepatomegaly
!Splenomegaly
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 1
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 1
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 2
!CXR
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;|CT Scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;|CT Scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;|MRI
! style="background: #4479BA; color: #FFFFFF; text-align: center;|MRI
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Tuberculosis
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Tuberculosis
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| style="background: #F5F5F5; padding: 5px;" |
* Close contact with TB+ person
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |↑
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| style="background: #F5F5F5; padding: 5px;" |
* [[Friction rub]]
* [[Heart sounds#Fourth%20heart%20sound%20S4|S4]]
* Distant [[heart sounds]]
* Fine/coarse [[crackles]] upon auscultation of the lung
* Pericardial knock
* Pericardial rub
| style="background: #F5F5F5; padding: 5px;" |+
|−
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* Miled anemia
* Leukocytosis
|
* Pleural effusion
* Pericardial calcification
* Pericardial thickening
* Pericardial effusion
* Evidence of pulmonary TB
* Enlarged cardiac silhouette
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Calcification]] of the [[pericardium]]
* Thickened [[pericardium]]
* [[Pericardial effusion]]
* Back flow of blood into the [[IVC]] and [[hepatic veins]] (in contrast [[CT scan]])
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Pericardial effusion
* Pericardial thickening
* Mediastinal and tracheobronchial lymphadenopathy (with hilar sparing)
* Bowing of the interventricular septum toward the left ventricle during diastole
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Pericardial effusion]]
* [[Pericardial]] thickening
* Increased [[right ventricular]] dimensions
* Decreased [[left ventricular]] dimensions
* Abnormal septal motion
* Flattening of the [[left ventricular]] posterior wall during diastol
* Dilated [[inferior vena cava]]
* Dilated [[atrium]]
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| style="background: #F5F5F5; padding: 5px;" |
* Acid fast bacilli
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* [[Pericardiocentesis]]
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* [[Pericardial]] [[biopsy]] (If we can't find acid fast bacilli in sputum or [[pericardial fluid]])
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|-
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Idiopathic/Viral
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Idiopathic/Viral
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* Recent common cold
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Post cardiac surgery
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Post cardiac surgery
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* Cardiac surgery
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Post radiation
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Post radiation
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* Radiation
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Revision as of 15:44, 28 February 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview


Differentiating [Disease name] from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].

OR

As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].

Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]

On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
History Symptoms Physical examination
Lab Findings Imaging Histopathology
Chest pain Fever Cough Edema/Ascites JVP Heart/Lung sounds Hepatomegaly Splenomegaly Lab 1 CXR CT Scan MRI Echo/Sono
Constrictive pericarditis
Tuberculosis
  • Close contact with TB+ person
+ + + ± +
  • Miled anemia
  • Leukocytosis
  • Pleural effusion
  • Pericardial calcification
  • Pericardial thickening
  • Pericardial effusion
  • Evidence of pulmonary TB
  • Enlarged cardiac silhouette
  • Pericardial effusion
  • Pericardial thickening
  • Mediastinal and tracheobronchial lymphadenopathy (with hilar sparing)
  • Bowing of the interventricular septum toward the left ventricle during diastole
  • Acid fast bacilli
Idiopathic/Viral
  • Recent common cold
Post cardiac surgery
  • Cardiac surgery
Post radiation
  • Radiation
Connective tissue disease
Malignancy
Mesothelioma
Chronic renal failure
Asbestosis
Restrictive cardiomyopathy
Amyloidosis
Sarcoidosis
Hemochromatosis
Sclerodema
Endomyocardial fibrosis
Carcinoid heart disease
Post radiation
Diabetic cardiomyopathy
Hurler
Gaucher
Fabry
Wegener
Metastatic malignancies

References

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