Pericarditis physical examination

Pericarditis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
HIV
Post MI
Dressler's syndrome
Post-pericardiotomy
Radiation
Tuberculosis
Uremia
Malignancy
Differentiating Pericarditis from other Diseases
Epidemiology and Demographics
Screening
Natural History, Complications and Prognosis
Pericardial Effusion
Cardiac Tamponade
Constrictive Pericarditis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Pericardiocentesis
Pericardial Window
Pericardial Stripping
Treatment Related Videos
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Pericarditis physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Google Images
American Roentgen Ray Society Images of Pericarditis physical examination All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Pericarditis physical examination
CDC on Pericarditis physical examination
Pericarditis physical examination in the news
Blogs on Pericarditis physical examination
Directions to Hospitals Treating Type page name here
Risk calculators and risk factors for Pericarditis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

The classic sign of pericarditis is a friction rub. A careful 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.

Appearance of the Patient with Pericarditis

• Fever less than 39° C or 102.2° F
  • Patients who are elderly may not exhibit fever; however, they may be hypothermic especially those with renal failure.
• Chills (suppurative pericarditis and idiopathic (viral) pericarditis)
• Weakness
• Anxiety
• Pallor (may also indicate tuberculosis, uremia, neoplasia, and rheumatic carditis)

Heart

Ausculatory Phenomena:

1. Pericardial Rub(s): Usually heard with acute pericarditis, sometimes with subacute and chronic. This is the major indicator of pericarditis.
   • endopericardial rub: inflamed, scarred or tumor-invaded serosal surfaces
   • exopericardial rub: after sclerotherapy of effusions, between parietal pericardium and pleura or chest wall (occasionally)
   • endo-exopericardial rub: both of the above
   • pleuropericardial rub: pleuritis as a result of pleural or both pleural and pericardial both
2. Abnormal Heart Sounds:
   • Sounds are dampened as a result of fluid insullation
   • Hemodynamic changes diminish S₁ and S₂
3. Clicks: Ventricular volume shrinks disproportionately and psuedoprolapse/true prolapse of mitral and/or tricuspid valvular structures result in clicks.
4. Murmurs: are epiphenomena and may be present if there is coinciding heart disease, narrowing of a valve, aorta, pulmonary artery or another area of the heart.

Lungs

Rales are frequent examination findings, occasionally pleural fluid may present.

Extremities

1. May be poorly perfused in the setting of tamponade
2. Edema may be present in the setting of pericardial constriction

de:Perikarditis nl:Pericarditis sv:Hjärtsäcksinflammation