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Ayokunle Olubaniyi (talk | contribs)
Ayokunle Olubaniyi (talk | contribs)
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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>
{{familytree/start}}
{{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}}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 19:23, 20 February 2014

Management

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

References