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Effective management relieves pain with analgesics and immobilization using crutches, splints, braces, and restriction of weight bearing to the affected joint.
In severe disease, surgery may include arthrodesis or, in severe diabetic neuropathy, amputation. However, surgery risks further damage through nonunion and infection.
Source: Professional Guide to Diseases (Eighth Edition), 2005
The goal of treatment is to relieve symptoms and manage the underlying systemic disease. In acute idiopathic pericarditis and postthoracotomy pericarditis, treatment consists of bed rest as long as fever and pain persist, and nonsteroidal drugs, such as aspirin and indomethacin, to relieve pain and reduce inflammation. Post-MI patients should avoid nonsteroidal anti-inflammatory drugs and steroids because they may interfere with myocardial scar formation. If these drugs fail to relieve symptoms, corticosteroids may be used. Although corticosteroids produce rapid and effective relief, they must be used cautiously because episodes may recur when therapy is discontinued.
Infectious pericarditis that results from disease of the left pleural space, mediastinal abscesses, or septicemia requires antibiotics (possibly by direct pericardial injection), surgical drainage, or both. Cardiac tamponade may require pericardiocentesis. Signs of tamponade include pulsus paradoxus, jugular vein distention, dyspnea, and shock.
Recurrent pericarditis may necessitate partial pericardectomy, which creates a “window’’ that allows fluid to drain into the pleural space. In constrictive pericarditis, total pericardectomy to permit adequate filling and contraction of the heart may be necessary. Treatment must also include management of rheumatic fever, uremia, tuberculosis, and other underlying disorders.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Effective management relieves associated pain with an analgesic and immobilization, using crutches, splints, braces, and restriction of weight bearing.
In patients with severe disease, surgery may include arthrodesis or, in those with severe diabetic neuropathy, amputation. However, surgery risks further damage through nonunion and infection.
Source: Handbook of Diseases, 2003
The goal of treatment is to relieve symptoms and manage underlying systemic disease.
With acute idiopathic pericarditis, post-MI pericarditis, and postthoracotomy pericarditis, treatment consists of bed rest while fever and pain persist and nonsteroidal anti-inflammatory drugs, such as aspirin and indomethacin, to relieve pain and reduce inflammation.
If these drugs fail to relieve symptoms, corticosteroids may be used. Although corticosteroids produce rapid and effective relief, they must be used cautiously because episodes may recur when therapy is discontinued.
Infectious pericarditis that results from disease of the left pleural space, mediastinal abscesses, or septicemia requires antibiotics (possibly by direct pericardial injection), surgical drainage, or both. Cardiac tamponade may require pericardiocentesis. Signs of tamponade include paradoxical pulse, jugular vein distention, dyspnea, and shock.
Recurrent pericarditis may necessitate a partial pericardectomy, which creates a “window” that allows fluid to drain into the pleural space. In constrictive pericarditis, a total pericardectomy to permit adequate filling and contraction of the heart may be necessary. Treatment must also include management of rheumatic fever, uremia, tuberculosis, and other underlying disorders.
Source: Handbook of Diseases, 2003
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