The cardiovascular diseases

THE ACUTE PERICARDITIS

- Definition
- The Symptoms
- How to make the diagnosis?
- Diagnosis of assess gravity
- The Causes
- Evolution
- Treatment
- Conclusion

TREATMENT

1 - Goal

Making the pericarditis regress by fighting against the inflammation.

2 - Means

a - Medical means

- Rest;

- Aspirin and anti-inflammatory non-steroid drugs;

- Corticosteroids;

- Antituberculous treatment if tuberculosis is responsible for the pericarditis.

b - Surgical means

0pening the pericardium and ablation of a part of the pericardium.

3 - Indications

Aspirin is prescribed as a painkiller and as an anti-inflammatory drug (3 to 4 grams/day) only in case of an important inflammatory syndrome. A non-steroid anti-inflammatory drug might be more indicated in this case.

The aspirin 3 in 6 grams/day or anti-inflammatory non-steroid drugs, in particular colchicine, prevent relapses. Pericardiectomy is sometimes necessary to get through relapses.

Corticosteroids are reserved to serious shapes and to some causes, in the quickly degressive dosage of 0.5 mg/kg.

In slow shapes, a tuberculosis diagnosis ex juvantibus treatment can be undertaken, even in the absence of a categorical proof.

4 - Results

They are usually good in the viral pericarditis, which remains the predominant cause. The treatment does not act in the other cases. The pericarditis of the collagen diseases, the rheumatoid arthritis and the rheumatic fever quickly regress with the corticosteroids treatment.

5 - Surveillance

The elements useful to the diagnosis are also used for the surveillance: The clinical exam by the physician, blood samples, the electrocardiogram and the echocardiography will be regularly achieved.

Prolonged rest in bed is indicated because a persistent fatigue is frequent. The effusion regresses especially quickly since it has formed quickly and abundantly.

The aspirin treatment lasts one month in total by decreasing the daily dose of 500 mg/week progressively. In case of relapse, colchicine is systematically associated to aspirin.

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File last reviewed on dec 18, 2011