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Perikardita

Table of contents
Perikardita
Dry (fibrinous) pericardis
Vypotny (exudative) pericardis
Acute high-quality pericardis
Adhesive (adhesive) pericardis
The squeezing (konstriktivny) pericardis

Pericardis — an inflammation of visceral and/or parietal leaves of a pericardium of the infectious or noninfectious nature. Usually the pericardis is a syndrome of the main pathological process and much more rare is an independent disease.

Classification of perikardit

A. Klinicheskaya

On a current:
•  acute;
•  subacute;
•  chronic.

On existence of an exudate:
• fibrinous (dry);
•  vypotny.
•  serous;
•  purulent;
•  hemorrhagic.

On outcomes:
• with an absolute recovery;
• with formation of commissures;
•  konstriktivny.

B. Etiologicheskaya

Infectious:
•  virus;
•  bacterial;
• tubercular;
•  fungal;
•  seldom other infections;
•  perikardita at AIDS.

Noninfectious nature:
•  acute myocardial infarction (pericarditis epistenocardica, postinfarction syndrome of Dressler);
•  tumors (metastatic defeats, are more rare primary tumors);
•  perikardita at uraemia;
• beam;
•  at a sarcoidosis;
•  at introduction of drugs (novokainamid, gidralazin, an isoniazid, etc.);
•  at a myxedema.

At rheumatism and systemic lesions of connecting fabric. The hearts (a myocardium or a pericardium) tied with damages:
• heart injuries;
• pericardium sections during operations.

Note. Emergence of liquid (blood) in a pericardium is observed also at wounds of a pericardium (hemopericardium), at heart failure (hydrocardia).

Treatment of perikardit

As considerable number of perikardit are secondary, the result of defeat of a pericardium in many respects is defined by treatment and a current of a basic disease. At virus perikardita use non-steroidal anti-inflammatory drugs, is more rare — glucocorticoids. In certain cases topical treatment — drainage of a pericardium is required at purulent exudate, introduction of tsitostatik to a pericardium cavity at its tumoral defeat, aspiration of blood and introduction of fibrinolitik to a pericardium cavity at a hemopericardium, a pericardiocentesis and removal of an exudate at the accruing cardiac tamponade. The amount of liquid in a pericardium at a hypothyroidism begins to decrease after replacement hormonal therapy, however process of involution of a pericardis can be very slow.

At chronic cardial compression with a picture of chronic venous stagnation make a resection of the sites of a pericardium squeezing heart. Because tuberculosis as the reason of this disease, is on the first place, before operation it is reasonable to begin treatment with antitubercular drugs. Treatment of a tuberkulostatikama needs to be continued also after operation if histologic and microbiological researches confirmed the tubercular nature of an illness and also when tuberculosis as the reason of the squeezing pericardis at the patient, despite the lack of direct confirmations, nevertheless  cannot be excluded.



 
"Open arterial channel   Defects of the valve of a pulmonary artery"