Summary
Definition
History and exam
Key diagnostic factors
- neoplasia maligna
- presença de outros fatores de risco
- dispneia
- pressão venosa jugular (PVJ) elevada
- sons cardíacos distantes
- pulso paradoxal
- hipotensão
- taquicardia
- cirurgia ou intervenção cardíaca recente
- Tríade de Beck: hipotensão, sons cardíacos hipofonéticos e PVJ elevada
Other diagnostic factors
- dor torácica
- dor abdominal
- febre
- atrito pericárdico
Risk factors
- neoplasia maligna
- dissecção da aorta
- pericardite purulenta
- derrame pericárdico crônico extenso idiopático
- pós-cirurgia ou intervenção cardíaca
- tuberculose (TB)
- doença autoimune
- hipotireoidismo
- insuficiência renal em estágio terminal
- anticoagulação
Diagnostic investigations
1st investigations to order
- eletrocardiograma (ECG)
- ecocardiografia transtorácica
- radiografia torácica
- Hemograma completo
- velocidade de hemossedimentação/proteína C-reativa
- enzimas cardíacas
Investigations to consider
- TC cardíaca
- ressonância nuclear magnética (RNM) cardíaca
- cateterismo cardíaco
- fluido de pericardiocentese para cultura e citologia
Treatment algorithm
sem hemopericárdio, trauma ou derrame purulento
com hemopericárdio, trauma ou derrame purulento
Contributors
Authors
Antonio Abbate, MD, PhD
Ruth C. Heede Professor of Cardiovascular Medicine
Division of Cardiovascular Medicine
Berne Cardiovascular Research Center
University of Virginia School of Medicine
Charlottesville
VA
Disclosures
AA has received consultant fees from Kiniksa Pharmaceuticals. He is an author of references cited in this topic.
Acknowledgements
Dr Antonio Abbate would like to gratefully acknowledge Dr Vaikom S. Mahadevan, Dr Harsh Agrawal, Dr Jonathan Bella, Dr Liran Blum, and Dr Michael Spinelli, previous contributors to this topic.
Disclosures
VSM declares that he is a proctor for Edwards Lifesciences for transcatheter valves and also a proctor for Abbott for closure devices. HA, JB, LB, and MS declare that they have no competing interests.
Peer reviewers
Ramon Castello, MD
Professor of Medicine
Director of Echocardiography
Mayo Clinic
Jacksonville
FL
Disclosures
RC declares that he has no competing interests.
References
Key articles
Klein AL, Abbara S, Agler DA, et al. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013 Sep;26(9):965-1012.Full text Abstract
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Pericardite constritiva
- Cardiomiopatia restritiva
- Choque cardiogênico
More DifferentialsGuidelines
- 2015 ESC guidelines on the diagnosis and management of pericardial diseases
- Clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease
More GuidelinesPatient information
Insuficiência cardíaca: como posso me ajudar?
Insuficiência cardíaca
More Patient information
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