Inflammation of the sac-like layer that surrounds the heart to protect it.
It has many causes: infectious, neoplastic, autoimmune, renal insufficiency, hypothyroidism, etc.
It manifests itself as a sharp pain in the chest that can radiate to the neck, shoulders, back or abdomen. It gets worse when you lie down, take a deep breath, cough or swallow. Typically, it improves with sitting down and bending forward.
Diagnosis is based on clinical history, physical examination, electrocardiogram and may require imaging (chest x-ray, echocardiogram).
A patient with uncomplicated acute pericarditis can be treated on an outpatient basis. However, high-risk patients (high fever, significant pericardial effusion, heart failure and failure to respond to anti-inflammatory therapy) should be admitted to hospital for investigation. If a viral cause is suspected, rest and anti-inflammatory treatment will suffice. If a bacterial cause is suspected, antibiotic treatment and occasional drainage will be needed. In other situations, treatment will depend on the underlying condition.
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