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[[Pericarditis]] is a condition in which the sac-like covering surrounding the heart (the [[pericardium]]) becomes inflamed.  Symptoms of [[pericarditis]] include [[chest pain]] which increases with deep breathing and lying flat.
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==Epidemiology and Demographics==
Pericarditis most often affects men aged 20 - 50. It usually follows respiratory infections. [[Pericarditis]] in developed countries are usually due to viral infections such as [[echovirus]] and [[coxsackie virus]], while in developing countries it is usually secondary to [[tuberculosis]] or [[HIV]] infection. The incidence of pericarditis following [[MI]] has greatly reduced with the use of early [[thrombolytic]] agents and revascularization.


==Natural History, Complications and Prognosis==
is
Pericarditis is often self-limited and most people recover in 2 weeks to 3 months. However, the condition can be complicated by significant fluid buildup around the heart (a [[pericardial effusion]] or [[cardiac tamponade]]) and may require urgent intervention including [[pericardiocentesis]].  If scarring of the sac around the heart (the [[pericardium]]) occurs, then this is called [[constrictive pericarditis]] which may require surgical stripping of the scar.
a
 
condition
==Causes==
in
Pericarditis is usually a complication of viral infections, most commonly [[echovirus]] or [[coxsackie virus]].  In addition, pericarditis can be associated with diseases such as [[autoimmune disorders]], cancer, [[hypothyroidism]], and [[kidney failure]].  Often the cause of [[pericarditis]] remains unknown, or idiopathic.
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the
==Diagnosis==
covering
===Physical Examination===
surrounding
A careful physical examination must be performed to exclude the presence of [[cardiac tamponade]], a dangerous complication of pericarditis.  If [[cardiac tamponade]] is present, then [[pulsus paradoxus]], [[hypotension]], an elevated [[jugular venous pressure]] and [[peripheral edema]] may be present.
heart
 
becomes
===ECG===
Symptoms
In the presence of a large effusion or tamponade, there may be diminished voltage and [[electrical alternans]] (alternation of [[QRS complex]] amplitude or axis between beats).
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include
===Echocardiography===
increases
Echocardiographys is generally performed to assess for the presence of a [[pericardial effusion]] and to assess and monitor its size. Echocardiography is critical in confirming the clinical suspicion [[cardiac tamponade]]. 
with
 
deep
==Treatment==
breathing
In cases that are thought to be due to viral pericarditis, treatment includes [[aspirin]] or a [[nonsteroidal anti-inflammatory drug (NSAID)]] such as [[ibuprofen]] for inflammation of the [[pericardium]]. [[Corticosteroids]] such as [[prednisone]] and / or [[Colchicine]] may be be necessary in refractory cases. [[Diuretics]] may be prescribed to remove excess fluid in the [[pericardial sac]].
and
 
lying
==References==
most
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Revision as of 17:15, 22 June 2012

is a condition in which the covering surrounding heart becomes Symptoms of include increases with deep breathing and lying most often affects men aged 20 It usually follows respiratory developed countries are due to viral infections such as while developing it secondary or The incidence pericarditis following has greatly reduced use early agents Complications people recover 2 weeks 3 can be complicated by significant fluid buildup around may require urgent intervention including If scarring sac then this called surgical stripping complication commonly In associated diseases Often cause remains careful physical examination must performed exclude presence dangerous an elevated venous large effusion there diminished voltage amplitude axis between generally assess for monitor its Echocardiography critical confirming clinical suspicion cases that thought treatment includes drug inflammation necessary refractory prescribed remove excess