[Pericarditis and cardiac tamponade: urgent condition not only in cardiology]

Pericarditis is a condition with inflammation of the pericardium; however, most of these conditions are not infective and many of them are not even inflammatory. Pericarditis by its development can be acute, sub-acute and chronic, and later, recurring or relapsing. Apart from idiopathic, the causes of pericarditis are numerous, very often inflammatory, most frequently caused by viruses, or tumours and neoplasms, diseases of connective tissue, vasculitis, different allergic reactions, radiation, thyroid gland diseases, uraemia, dissection of aorta etc.

Accumulation of fluid in the pericardium in the amount sufficient to cause significant obstruction of blood inflow in chambers can cause cardiac tamponade. If it is not treated immediately, the outcome may be fatal. The most common causes are tumours, viruses or uraemia. Cardiac tamponade should be suspected in patients with a decrease in systemic arterial pressure or presence of hypotension, tachycardia, silent and discreet heart beats, increase in systemic venous pressure (Beck triad). Electrocardiogram may result in tachycardia, QRS complex is of smaller voltage, often of reversed polarity. The amount of effusion is estimated by echocardiography

The cause of pericarditis should always be searched for. On the other hand, during monitoring or treatment of numerous conditions which could be a frequent cause of pericarditis, the presence of pericardial effusion or cardiac tamponade should be suspected and detected in due time. A timely intervention--pericardiocentesis, can prevent the fatal outcome. Besides non-steroid anti-inflammatory medication, many prospective randomised studies propose colchicine as addition to the standard therapy. When opting for the proper treatment for pericarditis always keep in mind the current diagnosis and cause of this condition.