Acute Pericarditis

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

  • History:

    • Retrosternal chest pain

      • Sudden onset

      • Pleuritic

      • 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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