Diagnostic Tests for Pericarditis
Pericarditis: Diagnostic Tests
The list of diagnostic tests
mentioned in various sources as
used in the diagnosis of Pericarditis
includes:
Pericarditis Tests: Book Excerpts
Home Diagnostic Testing
These home medical tests may be relevant to Pericarditis:
- High Blood Pressure: Home Testing
- Heart Health: Home Testing:
Pericarditis Diagnosis: Book Excerpts
Diagnosis of Pericarditis: medical news summaries:
The following medical news items
are relevant to diagnosis of Pericarditis:
Diagnostic Tests for Pericarditis: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the diagnostic tests for Pericarditis.
Pericardial friction rub:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
Obtain a complete medical history, noting especially cardiac dysfunction. Has the patient recently had a myocardial infarction or cardiac surgery? Has he ever had pericarditis or a rheumatic disorder, such as rheumatoid arthritis or systemic lupus erythematosus? Does he have chronic renal failure or an infection? If the patient complains of chest pain, ask him to describe its character and location. What relieves the pain? What worsens it?
Take the patient’s vital signs, noting especially hypotension, tachycardia, an irregular pulse, tachypnea, and a fever. Inspect for jugular vein distention, edema, ascites, and hepatomegaly. Auscultate the lungs for crackles. (See Comparing auscultation findings, pages 480 and 481.)
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Pericardial friction rub:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
Obtain a complete medical history, noting especially cardiac dysfunction. Has the patient recently had a myocardial infarction or cardiac surgery? Has he ever had pericarditis or rheumatic disorder, such as rheumatoid arthritis or systemic lupus erythematosus? Does he have chronic renal failure or an infection? If the patient complains of chest pain, ask him to describe its character and location. What relieves the pain? What worsens it?
Take the patient’s vital signs, noting especially hypotension, tachycardia, irregular pulse, tachypnea, and fever. Inspect for jugular vein distention, edema, ascites, and hepatomegaly. Auscultate the lungs for crackles.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Pericardial Friction Rub:
Physical examination
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
A. Vital signs. Fever may be present with viral AP. Hypotension or pulsus paradoxus can occur with a large pericardial effusion or pericardial tamponade. Tachycardia may be caused by fever or tamponade (Chapter 7.12).
B. Cardiac auscultation. A quiet room is essential. The pathognomonic physical finding of AP is the pericardial friction rub that has been likened to creaking leather or a scratching sound (1–3). The rub may be evanescent and vary in intensity; hence, multiple attempts should be made to elicit this finding. The rub is best heard with the stethoscope diaphragm firmly applied to the chest wall at the left-lower sternal border at end-inspiration (2). Having the patient lean forward may be helpful. The classic friction rub occurs in three phases: atrial systole, ventricular systole, and ventricular diastole. However, eliciting all three phases is uncommon. The presence of a rub does not exclude a large pericardial effusion or cardiac tamponade (2,3).
Testing
A. Laboratory tests. AP is mainly a clinical diagnosis but many patients have an elevated erythrocyte sedimentation rate or leukocytosis. Patients with connective tissue disease may have a positive antinuclear antibody test. Creatine phosphokinase or troponin levels can be slightly elevated if the underlying myocardium is inflamed (3).
B. Electrocardiogram. The electrocardiogram (ECG) is the most useful clinical tool in the diagnosis of AP, as repolarization changes occur in up to 90% of patients (1,3). The most sensitive indicator of AP is diffuse, concave-upward ST-segment elevation. A less sensitive, but very specific, indicator of AP is PR-segment depression (2,4). In addition, the P wave and QRS complex are normal and reciprocal changes and Q waves are absent.
1. Later findings of AP include T-wave flattening and T-wave inversion, which typically occur several days after ST-segment elevation.
2. Early repolarization is limited to the precordial leads. Notching of the terminal component of the QRS complex is characteristic of early repolarization.
3. Low-voltage QRS complexes can be a clue to pericardial effusion.
C. Diagnostic imaging. Imaging studies are unnecessary in most patients with idiopathic or classic viral AP. However, if clinical signs of pericardial tamponade or a large effusion are present, echocardiography should be performed (3). Chest radiography may reveal a “water-bottle” heart if a large effusion is present.
Diagnostic assessment
The diagnosis of a pericardial friction rub depends largely on the patient’s history. Chest pain that is sharp, pleuritic, worsened with recumbency, and relieved by leaning forward is very suggestive of pericardial inflammation. Radiation of pain to the trapezius ridge is very characteristic as well. Inquiring about conditions associated with pericarditis is paramount (e.g., autoimmune disease, drugs, recent heart surgery, renal failure). The friction rub is best heard at end-inspiration with the patient leaning forward. The ECG is the most useful diagnostic test, but if there is evidence of cardiac tamponade, an echocardiogram should be obtained.
References
1. Marinella MA. Electrocardiographic manifestations and differential diagnosis of acute pericarditis. Am Fam Physician 1998;57:699–704.
2. Shabeti R. Acute pericarditis. Cardiol Clin 1990;8:639–644.
3. Dehmer GJ, O’Meara JJ. Update on acute pericarditis. Hosp Med 1995;31:39–44.
4. Baljepally R, Spodick DH. PR-segment deviations as the initial electrocardiographic response in acute pericarditis. Am J Cardiol 1998;81:1505–1506.
» READ BOOK EXCERPT ONLINE »
Source: The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter, 2000
Pericardial friction rub:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Take the patient’s vital signs, noting especially hypotension, tachycardia, irregular pulse, tachypnea, and fever. Inspect for jugular vein distention, edema, ascites, and hepatomegaly. Auscultate the lungs for crackles.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Pericardial friction rub:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
Obtain a complete medical history, noting especially cardiac dysfunction. Has the patient recently had a myocardial infarction or cardiac surgery? Has he ever had pericarditis or a rheumatic disorder, such as rheumatoid arthritis or systemic lupus erythematosus? Does he have chronic renal failure or an infection? If the patient complains of chest pain, ask him to describe its character and location. What relieves the pain? What worsens it?
Take the patient's vital signs, noting especially hypotension, tachycardia, an irregular pulse, tachypnea, and fever. Inspect for jugular vein distention, edema, ascites, and hepatomegaly. Auscultate the lungs for crackles. (See Comparing auscultation findings, pages 474 and 475.)
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Heart failure affects approximately 5 million people in the United States. It can be caused by a number of conditions and treatment options may vary...
Heart trouble may sound like a click away if you have mitral valve prolapse (MVP). But this common misfiring in the heart is seldom serious. Learn...
Learn what factors may dictate whether you need treatment to prevent an infection in your heart.
"I authorize the release of any medical or other information necessary to process this claim." Do you recognize these words? You should, if...
See full list of 4 related videos
» Next page: Diagnosis of Pericarditis
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
