Pericarditis or inflammation of the pericardium may present as acute or chronic pericarditis. If the inflammation also affects the heart muscle, it is called perimyocarditis. Acute pericarditis usually lasts up to three weeks. For the diagnosis of the disease, the typical symptoms of this condition, which are characterized by:

• Chest pain.
• Shortness of breath.
• Signs of inflammation such as fever, rapid pulse and rapid breathing.
• The stabbing pain usually occurs behind the sternum when lying down and with deep breathing, coughing or strong movements.

In the diagnosis of pericarditis, nonspecific inflammatory reactions are found in blood tests. Frequently, there are ST-segment ECG changes similar to those of myocardial infarction, as well as excitation regression disorders with negative T waves. Peripheral ECG amplitudes are decreased.

Echocardiography can also detect minor effusions due to inflammatory reactions. For differential diagnosis, an MRI can provide more information. In the case of compressive effusions, a puncture, i.e., a puncture at the site of the effusion, is performed to obtain fluid for examination. It is performed under local anesthesia.

What causes pericarditis and how is it diagnosed?

The cause of pericarditis is usually unexplained. However, in most patients, the underlying cause is probably an infection by certain viruses. This acute viral pericarditis is usually caused by enteroviruses, herpesviruses, adenoviruses and parvovirus B 19. In addition to viral pathogens, bacteria (especially mycobacterium tuberculosis, which causes tuberculosis), as well as fungi and parasites (very rarely) are also possible causes of infectious pericarditis.

In addition, autoimmune diseases (e.g. rheumatism), cancer (radiation used in therapies), tumors, metabolic diseases such as gout, kidney failure, consequences of heart surgery, heart attack may be the cause. However, it is possible in some cases, not to find an apparent cause for this disease.

The first thing to do is to take the patient’s medical history (anamnesis) and perform a physical examination. In the case of acute dry pericarditis, the physician listens for the characteristic rubbing sound over the heart region with a stethoscope. It is no longer detectable as soon as an effusion forms in the pericardium, i.e. when the dry form of pericarditis transforms into the exudative wet form. To confirm the diagnosis, they are useful:

• Electrocardiogram.
• Ultrasound of the heart.
• Some laboratory tests.

How are the diagnostic techniques for pericarditis applied?

Electrocardiogram (ECG) is a very important examination method for the diagnosis of acute pericarditis. Also with the ECG, changes corresponding to the course of the disease are shown. However, distinguishing it from a heart attack can sometimes be difficult, which makes it necessary to complement this study with other analyses.

Ultrasound examination of the heart (echocardiography) is indispensable if pericarditis is suspected. It is unremarkable in most patients with acute pericarditis as long as a pericardial effusion has not formed. However, if pericarditis is present, ultrasound examination provides important information about the size of the effusion and its effect on the pumping function of the heart. The examination may possibly indicate joint disease of the heart muscle.

Laboratory tests are important in differentiating between an infarction and acute pericarditis. However, the most important tests that are positive for myocardial infarction (troponin and creatine kinase) may also be positive for pericarditis if it has spread to the heart muscle (perimyocarditis). In addition, a blood count is performed and C-reactive protein, white blood cells (leukocytes) and blood sedimentation rate are determined. These laboratory values provide information about acute inflammation in the body.

Other studies such as a chest x-ray may also be used to detect or rule out lung disease (e.g., tuberculosis, lung tumor) as a possible cause of pericarditis with effusion. In other cases, a pericardiocentesis may be considered, for example, if bacterial disease or a tumor is suspected. If additional heart muscle disease is suspected, an MRI or CT scan may be appropriate.

Why use a Kalstein electrocardiograph to diagnose pericarditis?

Kalstein, is an equipment that is characterized by its ease of use through a touch screen, with electronics that allows lowering the noise level of the reading while automatically correcting the drift of the baseline. Other technical aspects of this equipment, as well as prices, forms of purchase and quotation can be consulted in the link HERE.