Causing Chest Discomfort or Pain
Acute Pericarditis is often due to inflammation of parietal pericardium, a thin layer of specialized tissue that covers the outer surfaces of the heart
- Retrosternal chest pain
- Sudden onset
- Exacerbated by inspiration
- Worse when patient supine
- Improves when patient upright and leans forward
- Often radiates to neck, arms, left shoulder or back.
- Physical Examination:
- Audible friction rub in 85% - a high pitched scratchy or squeaky sound heard best at the left sternal border at end of expiration with the patient leaning forward.
- Intensity varies from moment to moment.
- Often it has 3 components – atrial systole, ventricular systole and rapid ventricular filling during early diastole.
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