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Pathogenesis, diagnosis and treatment of pericarditis

  • Chapter
Inflammatory Cardiomyopathy (DCMi)

Part of the book series: Progress in Inflammation Research ((PIR))

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Abstract

The spectrum of inflammatory pericardial syndromes includes acute, chronic and recurrent (relapsing) pericarditis, pericardial effusion and cardiac tamponade as well as constrictive pericarditis. The etiology of pericardial diseases is extensive, including infectious, non-infectious, systemic and autoimmune causes. A substantial proportion of idiopathic pericarditis represents viral infections or autoreactive pericarditis. The diagnosis of pericardial diseases is based on clinical presentation, electrocardiogram changes and echocardiographic findings. Pericardiocentesis, pericardioscopy with pericardial biopsy and contemporary pathology, immunohistochemistry and molecular biology techniques have extended the diagnostic armamentarium and contributed to etiopathogenetic understanding and treatment in pericardial diseases. Nevertheless, in uncomplicated cases, resolving to conventional anti-inflammatory treatment such a comprehensive approach is clinically not justified. On the other side, in chronic, recurrent or resistant forms an etiological diagnosis enables specific treatment. Furthermore, intrapericardial treatment after pericardiocentesis with cytostatic agents (cisplatin or thiotepa) in malignant pericardial effusions or sclerosing agents (triamcinolone, gentamycin) in chronic recurrent autoreactive effusions may prevent recurrences. Pericardiocentesis is life saving in cardiac tamponade and indicated in large effusions (> 20 mm in echocardiography in diastole), and suspected purulent, tuberculous and neoplastic pericarditis. Pericardiectomy is the only treatment for permanent constriction.

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Authors and Affiliations

  1. Department of Internal Medicine — Cardiology, University Hospital of Giessen and Marburg, Philipps-Universität Marburg, Baldingerstrasse 1, 35033, Marburg, Germany

    Bernhard Maisch, Konstantinos Karatolios & Sabine Pankuweit

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  1. Bernhard Maisch
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  2. Konstantinos Karatolios
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  3. Sabine Pankuweit
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  4. Arsen Ristic
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Editors and Affiliations

  1. Department of Cardiology and Pneumology, Charité—Universitätsmedizin Berlin Campus Benjamin Franklin, Hinderburgdamm 30, 12200, Berlin, Germany

    Heinz-Peter Schultheiss  & Michel Noutsias  & 

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Maisch, B., Karatolios, K., Pankuweit, S., Ristic, A. (2010). Pathogenesis, diagnosis and treatment of pericarditis. In: Schultheiss, HP., Noutsias, M. (eds) Inflammatory Cardiomyopathy (DCMi). Progress in Inflammation Research. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-8352-7_1

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  • DOI: https://doi.org/10.1007/978-3-7643-8352-7_1

  • Publisher Name: Birkhäuser Basel

  • Print ISBN: 978-3-7643-8351-0

  • Online ISBN: 978-3-7643-8352-7

  • eBook Packages: MedicineMedicine (R0)

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