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Comprehensive Cardiovascular Medicine in the Primary Care Setting pp 409–418Cite as

Pericardial Diseases

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Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Pericardial disease may present as an isolated condition or as a manifestation of systemic illness. Recognition of the clinical signs and symptoms of pericardial disorders in the primary care setting is critical for appropriate, and potentially lifesaving, triage and management. This chapter considers acute pericarditis and its potential complications relevant to the primary care provider: recurrent pericarditis, pericardial effusion, and constrictive pericarditis.

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References

  1. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2014. p. 128–34.

    Google Scholar 

  2. Spodick DH. The pericardium: a comprehensive textbook. New York: Marcel Dekker; 1997. p. 7.

    Google Scholar 

  3. Applegate RJ, Johnston WE, Vinten-Johansen J, Klopfenstein HS, Little WC. Restraining effect of intact pericardium during acute volume loading. Am J Phys. 1992;262:H1725–33.

    CAS  Google Scholar 

  4. Abbas AE, Appleton CP, Liu PT, Sweeney JP. Congenital absence of the pericardium: case presentation and review of literature. Int J Cardiol. 2005;98:21–5.

    Article  Google Scholar 

  5. Little WC, Freeman GL. Pericardial disease. Circulation. 2006;113:1622–32.

    Article  Google Scholar 

  6. LeWinter MM. Acute pericarditis. N Engl J Med. 2014;371:2410–6.

    Article  Google Scholar 

  7. Adler Y, Charron P, Imazio M, et al. 2015 ESC guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 2015;6:2921–64.

    Article  Google Scholar 

  8. Imazio M, Gaita F, LeWinter M. Evaluation and treatment of pericarditis. JAMA. 2015;314:1498–9.

    Article  CAS  Google Scholar 

  9. Voskuyl AE. The heart and cardiovascular manifestations in rheumatoid arthritis. Rheumatology. 2006;45(Suppl 4):iv4–7.

    Article  Google Scholar 

  10. Doria A, Petri M. Cardiac involvement in systemic lupus erythematosus. In: Doria A, Pauletto P, editors. The heart in systemic autoimmune disease. Amsterdam: Elsevier; 2004. p. 146–62.

    Google Scholar 

  11. Seferovic PM, Ristic AD, Maksimovic R, et al. Pericardial syndromes: an update after the ESC 2004 guidelines. Heart Fail Rev. 2013;18:255–66.

    Article  CAS  Google Scholar 

  12. Spodick DH. Pericardial rub. Prospective, multiple observer investigation of pericardial friction in 100 patients. Am J Cardiol. 1975;35:357–62.

    Article  CAS  Google Scholar 

  13. Wang K, Asinger RW, Marriott HJ. ST-segment elevation in conditions other than acute myocardial infarction. N Engl J Med. 2003;349:2128–35.

    Article  CAS  Google Scholar 

  14. Spodick DH. Diagnostic electrocardiographic sequences in acute pericarditis. Significance of PR segment and PR vector changes. Circulation. 1973;48:575–80.

    Article  CAS  Google Scholar 

  15. Spodick DH. Electrocardiogram in acute pericarditis. Distributions of morphologic and axial changes by stages. Am J Cardiol. 1974;33:470–4.

    Article  CAS  Google Scholar 

  16. Ginzton LE, Laks MM. The differential diagnosis of acute pericarditis from the normal variant: new electrocardiographic criteria. Circulation. 1982;65:1004–9.

    Article  CAS  Google Scholar 

  17. Bonnefoy E, Godon P, Kirkorian G, Fatemi M, Chevalier P, Touboul P. Serum cardiac troponin I and ST-segment elevation in patients with acute pericarditis. Eur Heart J. 2000;21:832–6.

    Article  CAS  Google Scholar 

  18. Brandt RR, Filzmaier K, Hanrath P. Circulating cardiac troponin I in acute pericarditis. Am J Cardiol. 2001;87:1326–8.

    Article  CAS  Google Scholar 

  19. Imazio M, Brucato A, Barbieri A, et al. Good prognosis for pericarditis with and without myocardial involvement: results from a multicenter, prospective cohort study. Circulation. 2013;128:42–9.

    Article  CAS  Google Scholar 

  20. Imazio M, Demichelis B, Cecchi E, et al. Cardiac troponin I in acute pericarditis. J Am Coll Cardiol. 2003;42:2144–8.

    Article  CAS  Google Scholar 

  21. Imazio M, Demichelis B, Parrini I, et al. Day-hospital treatment of acute pericarditis: a management program for outpatient therapy. J Am Coll Cardiol. 2004;43:1042–6.

    Article  Google Scholar 

  22. Spodick DH. Risk prediction in pericarditis: who to keep in hospital? Heart. 2008;94:398–9.

    Article  Google Scholar 

  23. Arunasalam S, Siegel RJ. Rapid resolution of symptomatic acute pericarditis with ketorolac tromethamine: a parenteral nonsteroidal antiinflammatory agent. Am Heart J. 1993;125:1455–8.

    Article  CAS  Google Scholar 

  24. Imazio M, Brucato A, Cemin R, et al. A randomized trial of colchicine for acute pericarditis. N Engl J Med. 2013;369:1522–8.

    Article  CAS  Google Scholar 

  25. Lilly LS. Treatment of acute and recurrent idiopathic pericarditis. Circulation. 2013;127:1723–6.

    Article  Google Scholar 

  26. Imazio M, Bobbio M, Cecchi E, et al. Colchicine in addition to conventional therapy for acute pericarditis: results of the COlchicine for acute PEricarditis (COPE) trial. Circulation. 2005;112:2012–6.

    Article  CAS  Google Scholar 

  27. Imazio M, Cecchi E, Demichelis B, et al. Indicators of poor prognosis of acute pericarditis. Circulation. 2007;115:2739–44.

    Article  Google Scholar 

  28. Imazio M, Bobbio M, Cecchi E, et al. Colchicine as first-choice therapy for recurrent pericarditis: results of the CORE (COlchicine for REcurrent pericarditis) trial. Arch Intern Med. 2005;165:1987–91.

    Article  CAS  Google Scholar 

  29. Sagrista-Sauleda J, Merce J, Permanyer-Miralda G, Soler-Soler J. Clinical clues to the causes of large pericardial effusions. Am J Med. 2000;109:95–101.

    Article  CAS  Google Scholar 

  30. Imazio M, Brucato A, Cumetti D, et al. Corticosteroids for recurrent pericarditis: high versus low doses: a nonrandomized observation. Circulation. 2008;118:667–71.

    Article  CAS  Google Scholar 

  31. Ben-Horin S, Bank I, Guetta V, Livneh A. Large symptomatic pericardial effusion as the presentation of unrecognized cancer: a study in 173 consecutive patients undergoing pericardiocentesis. Medicine. 2006;85:49–53.

    Article  Google Scholar 

  32. Permanyer-Miralda G. Acute pericardial disease: approach to the aetiologic diagnosis. Heart. 2004;90:252–4.

    Article  CAS  Google Scholar 

  33. Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003;349:684–90.

    Article  Google Scholar 

  34. Roy CL, Minor MA, Brookhart MA, Choudhry NK. Does this patient with a pericardial effusion have cardiac tamponade? JAMA. 2007;297:1810–8.

    Article  CAS  Google Scholar 

  35. Curtiss EI, Reddy PS, Uretsky BF, Cecchetti AA. Pulsus paradoxus: definition and relation to the severity of cardiac tamponade. Am Heart J. 1988;115:391–8.

    Article  CAS  Google Scholar 

  36. Spodick DH, Usher BW. Electrical alternans. Am Heart J. 1972;84:574–5.

    Article  CAS  Google Scholar 

  37. Pande AN, Lilly LS. Pericardial disease. In: Solomon SD, editor. Essential echocardiography. Totowa: Humana Press; 2007. p. 191–208.

    Chapter  Google Scholar 

  38. Klein AL, Abbara S, Agler DA, et al. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease. J Am Soc Echocardiogr. 2013;26:965–1012.

    Article  Google Scholar 

  39. Alter P, Figiel JH, Rupp TP, et al. MR, CT, and PET imaging in pericardial disease. Heart Fail Rev. 2013;18:289–306.

    Article  CAS  Google Scholar 

  40. Merce J, Sagrista-Sauleda J, Permanyer-Miralda G, Soler-Soler J. Should pericardial drainage be performed routinely in patients who have a large pericardial effusion without tamponade? Am J Med. 1998;105:106–9.

    Article  CAS  Google Scholar 

  41. Mayosi BM, Burgess LJ, Doubell AF. Tuberculous pericarditis. Circulation. 2005;112:3608–16.

    Article  Google Scholar 

  42. Sagrista-Sauleda J, Angel J, Permanyer-Miralda G, Soler-Soler J. Long-term follow-up of idiopathic chronic pericardial effusion. N Engl J Med. 1999;341:2054–9.

    Article  CAS  Google Scholar 

  43. Syed FF, Schaff HV, Oh JK. Constrictive pericarditis -- a curable diastolic heart failure. Nat Rev Cardiol. 2014;11:530–44.

    Article  Google Scholar 

  44. Bertog SC, Thambidorai SK, Parakh K, et al. Constrictive pericarditis: etiology and cause-specific survival after pericardiectomy. J Am Coll Cardiol. 2004;43:1445–52.

    Article  Google Scholar 

  45. Welch TD, Ling LH, Espinosa RE, et al. Echocardiographic diagnosis of constrictive pericarditis: Mayo Clinic criteria. Circ Cardiovasc Imaging. 2014;7:526–34.

    Article  Google Scholar 

  46. Cremer PC, Kwon DH. Multimodality imaging of pericardial disease. Curr Cardiol Rep. 2015;17:24–8.

    Article  Google Scholar 

  47. Talreja DR, Edwards WD, Danielson GK, Schaff HV, Tajik AJ, Tazelaar HD, Breen JF, Oh JK. Constrictive pericarditis in 26 patients with histologically normal pericardial thickness. Circulation. 2003;108:1852–7.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Fidencio Saldana & Leonard S. Lilly

Authors
  1. Fidencio Saldana
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  2. Leonard S. Lilly
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Correspondence to Leonard S. Lilly .

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Editors and Affiliations

  1. Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Peter P. Toth

  2. Cardiovascular Division, Harvard Medical School Brigham & Women’s Hospital, Boston, MA, USA

    Christopher P. Cannon

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Saldana, F., Lilly, L.S. (2019). Pericardial Diseases. In: Toth, P., Cannon, C. (eds) Comprehensive Cardiovascular Medicine in the Primary Care Setting. Contemporary Cardiology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-97622-8_22

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  • DOI: https://doi.org/10.1007/978-3-319-97622-8_22

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-97621-1

  • Online ISBN: 978-3-319-97622-8

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