Acute Pericarditis: Understanding Its Clinical Characteristics

Acute pericarditis is a condition characterized by sudden inflammation of the pericardium, the sac-like membrane surrounding the heart. Its clinical features can vary depending on the underlying cause and the amount of fluid accumulated in the pericardial space.

Types and Symptoms of Acute Pericarditis

Dry Pericarditis

Dry pericarditis, also known as fibrinous or minimal exudative pericarditis, is often marked by significant chest pain. This pain typically occurs in the precordial region and is frequently described as sharp or stabbing. It may intensify with certain activities such as coughing, deep breathing, or lying down, and may improve when sitting up or leaning forward. This type of pericarditis usually involves little or no fluid accumulation around the heart.

Effusive Pericarditis

On the other hand, effusive pericarditis involves a larger volume of fluid build-up in the pericardial cavity. In such cases, particularly in children, the symptoms may differ significantly from those of dry pericarditis. Chest pain may not be the primary complaint. Instead, patients may experience shortness of breath, chest tightness, profuse sweating, restlessness, and fluctuating blood pressure. These signs can indicate a more severe condition and may lead to life-threatening complications such as cardiac tamponade.

Diagnostic and Treatment Approaches

When a large amount of fluid accumulates rapidly, urgent medical intervention is necessary. A procedure known as pericardiocentesis may be performed to drain the excess fluid and relieve pressure on the heart. The collected fluid is then analyzed and cultured to identify the causative organism, especially in suspected cases of infectious pericarditis. Early diagnosis and targeted treatment are crucial in preventing complications and improving patient outcomes.