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Imaging Studies for Cardiovascular System I:Echocardiography01:17

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Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
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Acute Pericarditis: Rapid Evidence Review.

Thomas A Peterson1, Sean P Turner1, Katelyn A Dolezal2

  • 1Madigan Army Medical Center Family Medicine Residency Program, Tacoma, Washington; Uniformed Services University of the Health Sciences, Bethesda, Maryland; University of Washington School of Medicine, Seattle, Washington.

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Acute pericarditis, often viral and idiopathic, affects 4.4% of emergency patients with nonischemic chest pain. Diagnosis requires specific clinical and ECG findings, with NSAIDs as first-line treatment.

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Acute pericarditis is pericardial inflammation, affecting 4.4% of emergency department patients with nonischemic chest pain.
  • Most cases are idiopathic, presumed viral, and more prevalent in men.

Purpose of the Study:

  • To outline the diagnostic criteria and management strategies for acute pericarditis.
  • To highlight key diagnostic findings and treatment options, including first-line and alternative therapies.

Main Methods:

  • Diagnosis requires at least two criteria: pericardial effusion, pleuritic chest pain, pericardial friction rub, or specific electrocardiographic changes.
  • Transthoracic echocardiography is essential for assessing effusions and complications.
  • Electrocardiography (ECG) findings include PR depressions and diffuse ST elevations.

Main Results:

  • Pericardial friction rubs are highly specific but transient (18-84% prevalence).
  • Classic ECG changes include PR-segment depressions and diffuse, concave, upward ST-segment elevations.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are the primary treatment.

Conclusions:

  • Acute pericarditis diagnosis relies on a combination of clinical presentation, physical exam, and ECG findings.
  • NSAIDs are first-line treatment; glucocorticoids and colchicine are used in specific situations or for recurrence prevention.
  • Hospital admission is recommended for high-risk patients to monitor for complications.