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| ==Management== | | ==Management== |
| Shown below is an algorithm showing acute pericarditis management.<ref name="pmid15120056">{{cite journal| author=Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y et al.| title=Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology. | journal=Eur Heart J | year= 2004 | volume= 25 | issue= 7 | pages= 587-610 | pmid=15120056 | doi=10.1016/j.ehj.2004.02.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15120056 }} </ref>
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| {{familytree/start |summary=PE diagnosis Algorithm.}} | | {{familytree | | | | | | | | A01 | | |A01=}} |
| {{familytree | | | | | | | A01 | |A01=<div style="float: left; text-align: left; line-height: 150% ">'''Characterize the symptoms:'''<br> | | {{familytree | | | | | | | | |!| | | | |}} |
| ❑ Prodrome:<br>
| | {{familytree | | | | | | | | B01 | | | |B01=}} |
| ♦[[Fever]] <br> ♦[[Malaise]] <br> ♦[[Myalgia]]<br>
| | {{familytree | | | | | | | | |!| | | | | |}} |
| ❑ Retrosternal or left precordial [[chest pain]]:<br>
| | {{familytree | | | | | | | | C01 |-| C02 | | | |C01=|C02=}} |
| ♦Radiates to trapezius ridge<br> ♦Can be pleuritic <br> ♦Can simulate ischemia <br> ♦Varies with posture <br>
| | {{familytree | | | | | | | | |!| | | |}} |
| </div> }}
| | {{familytree | | | | | | | | D01 | | | |D01=}} |
| {{familytree | | | | | | | |!| | | | | | | }} | | {{familytree | | | | | | | | |!| |}} |
| {{familytree | | | | | | | C01 | | | | | | |C01=<div style="float: left; text-align: left; line-height: 150% ">'''Auscultation:'''<br> | | {{familytree | | | | | | | | E01 | | | |E01=}} |
| ❑ [[Pericardial rub]]<br>
| | {{familytree | | | | | | | | |!| | | | |}} |
| ♦Monophasic<br> ♦Biphasic<br> ♦Triphasic <br>
| | {{familytree | | | | | | | | F01 | | | |F01=}} |
| </div>}}
| | {{familytree | | | | | | | | |!| | | | |}} |
| {{familytree | | | | | | | |!| | | | | | | }} | | {{familytree | | | | | | | | G01 | | | | |G01=}} |
| {{familytree | | | | | | | D01 | | | | | | |D01=<div style="float: left; text-align: left; line-height: 150% ">'''Perform ECG:'''<br> | | {{familytree | | | | |,|-|-|-|^|-|-|-|.| | | | |}} |
| ❑ Convexly elevated J-ST segment<br>
| | {{familytree | | | | H01 | | H02 | | H03 | | | |H01=|H02=|H03=}} |
| ❑ Determine ECK staging:<br> ♦ Stage I: anterior and inferior concave ST segment elevation. PR segment 7,19 deviations opposite to P polarity <br> ♦ Early stage II: ST junctions return to the baseline, PR deviated <br> ♦ Late stage II: T waves progressively flatten and invert <br> ♦ Stage III: generalised T wave inversions <br> ♦ Stage IV: ECG returns to prepericarditis state
| | {{familytree | | | | |`|-|-|-|+|-|-|-|'| | | |}} |
| </div>}}
| | {{familytree | | | | | | | | I01 | | | | | | | |I01=}} |
| {{familytree | | | | | | | |!| | | | | | | | }} | | {{familytree | |,|-|-|-|v|-|-|^|-|-|v|-|-|-|.| | | |}} |
| {{familytree | | | | | | | E01 | | | | | | | | |E01= <div style="float: left; text-align: left; line-height: 150% ">'''Echocardiography:'''<br> ❑ Effusion types B- D according to Horowitz classification: <br> ♦ Type A: No effusion <br> ♦ Type B: Separation of epicardium and pericardium (3–16 ml)<br> ♦ Type C 1: Systolic and diastolic separation of epicardium and pericardium (small effusion >16 ml)<br> ♦ Type C 2: Systolic and diastolic separation of epicardium and pericardium with attenuated pericardial motion<br> ♦ Type D: Pronounced separation of epicardium and pericardium with large echo- free space<br> ♦ Type E: Pericardial thickening (>4 mm)</div>}} | | {{familytree | J01 | | J02 | | | | J03 | | J04 | | |J01=|J02=|J03=|J04=}} |
| {{familytree | | | |,|-|-|-|^|-|-|-|.| | | | | }} | | {{familytree | |`|-|-|-|^|-|-|v|-|-|^|-|-|-|'| | |}} |
| {{familytree | | | F01 | | | | | | F02 | | | | |F01='''Evidence of pericardial effusion''' |F02=<div style="float: left; text-align: left; line-height: 150% ">'''Order lab tests:''' <br> ❑ Inflammation markers: <br>♦[[ESR]] <br> ♦[[CRP]] <br> ♦[[LDH]] <br> ❑ Markers of myocardial lesion:<br> ♦[[Troponin I]] <br> ♦[[CK MB]]</div> }} | | {{familytree | | | | | | | | K01 | | | |K01=}} |
| {{familytree | |,|-|^|-|.| | | | | |!| | | | }} | | {{familytree | | | | | | | | |!| | | | | | |}} |
| {{familytree | G01 | | G02 | | | | G03 | | |G01=Large recurrent effusion| G02=Signs of cardiac tamponade|G03= Perform [[chest X-Ray]]: <br>❑ “water bottle” heart shadow}} | | {{familytree | | | | | | | | L01 | | | |L01=}} |
| | {{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | }} |
| {{familytree/end}} | | {{familytree/end}} |
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| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |