Pericarditis

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The main disorder of the pericardium is pericarditis.
pericarditis, is often complicated by development of an effusion.
In acute pericarditis there is acute inflammation of the pericardium,in which both pericardial surfaces are coated with a fibrin-rich acute inflammatory exudate.
Loss of smoothness leads to the clinical sign of a friction rub.
The most common cause of acute pericarditis is myocardial infarction.

The next most common cause encountered in community practice is the transient pericarditis that can occur in some viral disorders;
many are probably sub-clinical and most are clinically mild, presenting to the family practitioner and rarely requiring hospitaltreatment. Other causes of clinically significant pericarditis are:
Post-operative, following open heart surgery. The pericarditis is diffuse, involving the entire pericardial surface, and heals by fibrosis, largely obliterating the pericardial cavity.
Bacterial pericarditis, usually associated with severe bacterial infection of the lungs.
An important cause in the past was pulmonary TB, producing tuberculous pericarditis.
Healing by fibrosis became heavily calcified and rigid, often producing restriction to cardiac filling
(constrictive pericarditis).
Malignant pericarditis, usually due to infiltration of the pericardium by local spread from a primary bronchial tumour. Less commonly the cause is blood-borne metastases from a distant site, e.g. malignant melanomatosis.
Uraemic pericarditis, rarely seen now that chronic renal failure can be treated by dialysis and transplantation.
Immune pericarditis. Formerly an important component of the pancarditis associated with rheumatic
fever, it is now rare. Occasionally, patients with systemic autoimmune disease, such as SLE and rheumatoid
disease, may develop pericarditis.
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