Acute pericarditis. Many pericarditis proceed relatively easily and end with recovery even in the absence of targeted treatment. At one time, this was the reason for the unreasonable inclusion in the clinical classifications of so-called acute benign pericarditis, presumably viral etiology.

However, the nature of most of these pericarditis was allergic: viral pericarditis only occur in combination with viral myocarditis (this is indirectly confirmed by the fact that viral pleurisies and peritonitis are extremely rare).

However, the definition of the etiology of pericarditis after its detection is often very difficult task.

Causes The disease can be caused by an infectious agent, pericarditis can be a complication of chronic diseases, including tuberculosis, rheumatism, kidney disease leading to uremia (aseptic pericarditis).

Sometimes pericarditis develops sharply in patients with pneumonia, as well as with myocardial infarction.

Symptoms The earliest and most frequent complaint of patients with acute pericarditis is pain in the region of the heart localized at the apex of the heart or at the bottom of the sternum radiating to the left arm, iodine left shoulder blade, neck, may epigastric. Pain resembles a picture of myocardial infarction or pleurisy. By nature, as a rule, she is strong, sometimes singing, dull. Patients complain of an unpleasant sensation and heaviness in the region of the heart. Heart pain is the main symptom of dry pericarditis.

The appearance of exudate and its rapid accumulation in the pericardial cavity causes pronounced dyspnea in patients. The patient notes the increase in dyspnea in the horizontal position, lying on the bed, so he is forced to assume the position of orthoppoe (sitting position); sometimes try to ease the condition by tilting the body forward. Dyspnea is usually accompanied by a dry cough. If irritation of the diaphragmatic nerve occurs, vomiting occurs.

In patients with nodostroy tamponade of the heart, some time after the onset of the disease, stagnation occurs in the system of the inferior and inferior vena cava, which causes swelling, enlargement of the liver, ascites, pa-. When percussion of the border of the heart with dry pericarditis is usually not changed.

With ekssudativpom pericarditis revealed a decrease, and often the disappearance of the apical impulse, which is associated with a large exudate. The boundaries of relative cardiac dullness increase in all directions.

There is also a tendency to increase absolute cardiac dullness. There is swelling of the cervical veins. With dry pericardial heart tops, as a rule, are not changed or slightly muffled. With exudative tops are sharply muffled, there is a sinus tachycardia.

If there is a small amount of effusion, then with dry fibrinous pericardial and exudative, a pericardial friction noise appears.

Noise is better heard in the sitting position, its character is high, scratching, is determined to the left of the parastral line and on the sternum. The noise of friction of the pericardium with accumulation of exudate weakens when the condition improves, appears again. There is a decrease in blood pressure, more systolic.

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