MANAGEMENT OF HEART DISEASE

If there is an acute inflammation in the pericardium is called acute pericarditis.

   1. Viral infection: It is the most common causes of acute pericarditis.

   2. Acute myocardial infarction

   3. Other infection: Tubercular, Fungal, Pyogenic etc

   4. Rheumatic fever, Rheumatic arthritis

   5. Post-pericardial syndrome

   6. Post myocardial syndrome

   7. Uraemia

   8. Trauma

   9. Hypothyroidism

   10. Gout

   11. Drugs like Procainamide ,Hydralazine ,Reserpine etc.

   12. Neoplastic invasion

   1. Central or pericardial chest pain with radiation to neck and shoulder.

   2. Pericardial rub: High pitched, heard in systole and diastole mainly in the time of atrial systole.

   3. Fever

   4. Tachycardia

   5. Pericardial effusion

   6. Pericardial temponade

   1. ECG:

           §ST segment is elevated and upward concavity present

           §T wave is uprighted

           § PR interval is depressed

  2. X-ray

           Large pericardial effusion

  3. Echocardiography:

           Pericardial effusions are described as small, moderate, or large based on the size of the echo-free space between the parietal and visceral pleura on two-dimensional echocardiography.

  4. Polymorphonuclear leucocytosis

  5. Positive Montaux test in Tubercular pericarditis.

   1. Non steroidal anti inflammatory drug (NSAID) can be used to relieve pain

   2. Corticosteroid is given in severe condition

   3. If steroid is non responsive, then colchicines should be given

   4. In case of viral pericarditis Hyperimmunoglobulin(In cytomego viral pericarditis) can be used but in Coxsacike B pericarditis Interferon alpha is used.

   5. In bacterial pericarditis antibiotic should be given.

   6. In tubercular pericarditis treated with a combination of 3 or 4 tuberculostic drug for 9 to 12 months, according to standard protocols.

   7. Uraemic pericarditis—responds within 1 to 2 weeks to dialysis.