Pericarditis chest pain

The most serious complication of pericarditis is cardiac tamponade which is manifested by shortness of breath and hypotension. Emergency pericardiocentesis is required. In most cases, the frequency and duration of dialysis should be increased after pericarditis develops. Pericarditis is an absolute indication for beginning haemodialysis if the patient has not been previously dialyzed. Indomethacin may be used in patients with chest pain, although its value has not been substantiated by placebo-controlled studies. 

Codeine, also known as methylmorpliine, C H2 NOt H20, is a colorless white crystalline substance, mp 154.9 C, slightly soluble in water, soluble in alcohol and chloroform, effloresces slowly in dry air. Codeine is derived from opium by extraction or by the methylation of morphine. For medical use, codeine is usually offered as the dichlotide, phosphate, or sulfate. Codeine is habit forming. Codeine is known to exacerbate urticaria (familiarly known as hives). Since codeine is incorporated in numerous prescription medicines for headache, heartburn, fatigue, coughing, and relief of aches and pains, persons with a history of urticaria should make this fact known to their physician. Codeine is sometimes used ill cases of acute pericarditis to relieve severe chest pains in early phases of disease. Codeine is sometimes used in drug therapy of renal (kidney) diseases. 

In Table 4.3 the most frequent causes of ST-segment elevation, aside from IHD (typical and atypical ACS), are shown. At the time of making the differential diagnosis in clinical practice, out of all these different entities the possibility of a pericarditis or an early phase acute myopericarditis (Figures 4.48 and 4.49) should be kept in mind. These also cause chest pain that may complicate the diagnosis. 

Yet the clinician usually makes the diagnosis of uremia when patients with high BUN (alOO mg/dl) and serum creatinine (alO mg/dl) levels develop symptoms of anorexia, nausea, vomiting, abnormal taste in the mouth, uremic fetor, insomnia, loss of energy and libido, dyspnea from pulmonary congestion, or chest pain from pericarditis. Such patients may also exhibit normocytic normochromic anemia, metabolic acidosis, hyperkalemia, hyperphosphatemia, hypocalcemia, or hypo-albuminemia. 

The usual infectious dose is considered to be 10 organisms through inhalation. Symptoms are not specific to the disease, and it may be mistaken for a viral illness or atypical pneumonia. The incubation period is from 10 to 20 days. Patients may experience fever, cough, and chest pain as soon as 10 days after exposure. Although somewhat rare, other symptoms that may appear include chills, headache, weakness, malaise, severe sweats, hepatitis, endocarditis, pericarditis, pneumonitis, and generalized infections. Patients are not critically iU and, in most cases, the illness lasts from 2 days to 2 weeks. 

Cardiovascular system Arrhythmias Hypotension Hypertension Congestive heart failure Angina and/or chest pain Pericarditis Cardiomyopathy... 

A 38-year-old man with ulcerative colitis who had taken mesalazine for many years was switched to balsalazide 2.25 g tds and prednisolone 15 mg/day. However, 14 days later, while his bowel symptoms were improving, he developed intermittent chest pain (not typical of ischemia or pericarditis). Cardiac troponin I and C reactive protein were raised and there was widespread T wave inversion. Echocardiography showed apical and posterior segment wall motion abnormality with no effusion. A diagnosis of myocarditis was made, and balsalazide was withdrawn. His cardiac symptoms resolved within 48 hours. 

An 85-year-old male with a dual chamber ICD placed 4 years ago for VT is admitted for pleuritic chest pain. He also states that he has been having an "electrical" sensation in his chest for the past 2 weeks. A 12-lead ECG demonstrates changes consistent with pericarditis. Evaluation of the ICD up to this point in time has been unremarkable. ICD interrogation now shows the following lead impedances and real-time EGMs. There is no atrial pacing capture or output seen, even at maximum output. 

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