Tuberculous pericarditis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Tuberculous pericarditis does not have the typical classic presentation of an acute pericarditis (sudden-onset chest pain and typical ECG changes). Instead, it most commonly presents with systemic signs and symptoms. If left untreated, tuberculous pericarditis can be complicated by constrictive pericarditis which can then ultimately lead to heart failure. Common complications of tuberculous pericarditis include acute pericarditis, constrictive pericarditis, cardiac tamponade, and heart failure.
Natural History, Complications, and Prognosis
Natural History
- Tuberculous pericarditis does not have the typical classic presentation of an acute pericarditis (sudden-onset chest pain and typical ECG changes).
- Instead, it most commonly presents with systemic signs and symptoms:[1]
- Cough (94%)
- Dyspnea (88%)
- Chest pain (76%)
- Fever (70%)
- Night sweats (56%)
- Orthopnea (53%)
- Weight loss (48%)
- If left untreated, tuberculous pericarditis can be complicated by constrictive pericarditis which can then ultimately lead to heart failure.[2]
Complications
- Common complications of tuberculous pericarditis include:[3][4]
Prognosis
- Antituberculous therapy has dramatically improved the prognosis of tuberculous pericarditis.
- It is evident from the decrease in mortality rate with time:
- 30 - 40% in North America (1953 - 1970) and 12% (1970 - 1986)[5]
- 16% in Cape Town (1952 - 1957)
- Most untreated patients (up to 90% at 1 year) die from tuberculous dissemination or heart failure, the average survival being 3 to 4 months.
References
- ↑ Fowler, Noble O. (1991). "Tuberculous Pericarditis". JAMA: The Journal of the American Medical Association. 266 (1): 99. doi:10.1001/jama.1991.03470010103039. ISSN 0098-7484.
- ↑ Chang SA (November 2017). "Tuberculous and Infectious Pericarditis". Cardiol Clin. 35 (4): 615–622. doi:10.1016/j.ccl.2017.07.013. PMID 29025551.
- ↑ Chang SA (November 2017). "Tuberculous and Infectious Pericarditis". Cardiol Clin. 35 (4): 615–622. doi:10.1016/j.ccl.2017.07.013. PMID 29025551.
- ↑ Fowler, Noble O. (1991). "Tuberculous Pericarditis". JAMA: The Journal of the American Medical Association. 266 (1): 99. doi:10.1001/jama.1991.03470010103039. ISSN 0098-7484.
- ↑ Quale JM, Lipschik GY, Heurich AE (June 1987). "Management of tuberculous pericarditis". Ann. Thorac. Surg. 43 (6): 653–5. doi:10.1016/s0003-4975(10)60243-3. PMID 3109338.