I30.9
DESCRIPTION
An inflammation of the pericardium. Causes include viral or bacterial and autoimmune disease. The commonest cause is viral but the clinician should entertain a high index of suspicion for tuberculous and bacterial pericarditis as these require specific antimicrobial treatment.
DIAGNOSTIC CRITERIA
Inflammation of the pericardium:
- Classical presentation of viral pericarditis, loud pericardial rub and chest pain that is relieved by sitting up. Children often do not complain of chest pain.
- Acute septic pericarditis may occur in patients with septicaemia.
TB pericarditis
TB pericarditis may present as pericardial effusion (most cases), effusive constrictive pericarditis or constrictive pericarditis.
Clinical features include:
- chronic cough,
- dyspnoea,
- chest pain,
- fever,
- night sweats,
- orthopnoea,
- and weight loss.
Severe pericardial pain is uncommon.
Investigations
- Exclude TB.
- Echocardiogram.
MEDICINE TREATMENT
Treat the cause.
For tuberculous and bacterial pericarditis treatment See Pericardial Effusion .
Viral pericarditis:
NSAIDs e.g.
- Ibuprofen, oral, 5 mg/kg/dose 6 hourly.
REFERRAL
- All patients in whom the cause is unidentified or merits further referral.