小结
定义
病史和体格检查
关键诊断因素
- chest pain
- pericardial rub
其他诊断因素
- fever
- myalgias
- signs of right-sided heart failure
危险因素
- male sex
- age 20 to 50 years
- transmural myocardial infarction (MI)
- cardiac surgery
- neoplasm
- viral and bacterial infections
- uremia or on dialysis
- systemic autoimmune disorders
- pericardial injury
- mediastinal radiation
诊断性检查
首要检查
- ECG
- serum troponin
- pericardial fluid/blood culture
- erythrocyte sedimentation rate (ESR)
- CRP
- serum BUN
- CBC
- chest x-ray
- echocardiography
需考虑的检查
- chest CT or cardiac MRI
- pericardiocentesis/biopsy
治疗流程
suspected pericarditis
purulent
non-purulent
recurrent disease
撰稿人
专家顾问
Antonio Abbate, MD, PhD
Professor of Cardiology
Division of Cardiovascular Medicine
University of Virginia
Charlottesville
VA
利益声明
AA has received grant support and consultant fees from Applied Clinical Intel, Astra Zeneca, Cromos Pharma, Eli Lilly, Implicit Biosciences, Janssen, Kiniksa, Merck, Novartis, Novo Nordisk, Olatec, R-Pharm, and Serpin Pharma.
鸣谢
BMJ Best Practice would like to gratefully acknowledge Dr Katherine Wu MD, a previous contributor to this topic.
利益声明
KW declares that she has no competing interests.
同行评议者
Susan Denfield, MD
Associate Professor of Pediatrics
Division of Pediatric Cardiology
Texas Children's Hospital
Houston
TX
利益声明
SD declares that she has no competing interests.
Shrilla Banerjee, MBMD, MRCP
Consultant Cardiologist
East Surrey Hospital
Surrey and Sussex NHS Trust
Redhill
UK
利益声明
SB declares that she has no competing interests.
参考文献
关键文献
Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 2015 Nov 7;36(42):2921-64.全文 摘要
Chiabrando JG, Bonaventura A, Vecchié A, et al. Management of acute and recurrent pericarditis: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 Jan 7;75(1):76-92.全文 摘要
Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the evaluation and diagnosis of chest pain: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2021 Nov 30;144(22):e368-e454.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
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- Myocardial infarction or ischemia
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更多 鉴别诊断指南
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- 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain
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