Skip to Main Content

++

Condition/Disorder Synonyms

++

  • Dressler's syndrome

++

ICD-9-CM Codes

++

  • 420 Acute pericarditis

  • 420.0 Acute pericarditis in diseases classified elsewhere

  • 420.90 Acute pericarditis, unspecified

  • 420.91 Acute idiopathic pericarditis

  • 420.99 Other acute pericarditis

  • 423 Other diseases of pericardium

  • 423.0 Hemopericardium

  • 423.1 Adhesive pericarditis

  • 423.2 Constrictive pericarditis

  • 423.3 Cardiac tamponade

  • 423.8 Other specified diseases of pericardium

  • 423.9 Unspecified disease of pericardium

++

ICD-10-CM Codes

++

  • I30 Acute pericarditis

  • I30.0 Acute nonspecific idiopathic pericarditis

  • I30.1 Infective pericarditis

  • I30.8 Other forms of acute pericarditis

  • I30.9 Acute pericarditis, unspecified

  • I31 Other diseases of pericardium

  • I31.0 Chronic adhesive pericarditis

  • I31.1 Chronic constrictive pericarditis

  • I31.4 Cardiac tamponade

  • I31.8 Other specified diseases of pericardium

  • I31.9 Disease of pericardium, unspecified

  • I32 Pericarditis in diseases classified elsewhere

++

Preferred Practice Pattern

++
++

Key Features

++

Description

++

  • Inflammation of the pericardium (fibrous sac surrounding the heart)

  • Can be acute or chronic

++

Essentials of Diagnosis

++

  • Chest pain can be relieved by sitting up and leaning forward

  • Stethoscope: pericardial rub sound

  • Bacterial infection: mycobacterium tuberculosis

  • Acute to chronic

    • Acute < 6 weeks

    • Subacute 6 weeks to 6 months

    • Chronic > 6 months

  • Classification secondary to type of fluid

    • Serous

    • Purulent

    • Fibrinous

    • Caseous

    • Hemorrhagic

    • Post infarction (from a heart attack)

++

General Considerations

++

  • Can be misdiagnosed as a heart attack

  • Often the result of an infection

  • No change with exertion

  • Often unknown etiology

++

Demographics

++

  • Mostly men ages 20 to 50 years of age

++

Clinical Findings

++

Signs and Symptoms

++

  • Cardiac tamponade

  • Sharp stabbing chest pain

  • Pain can radiate into the upper trapezius muscle

  • Shortness of breath

  • Fatigue weakness

  • Swelling in the lower extremities

  • Anxiety

  • Diaphoresis

  • Dry cough

  • Fever

  • Crackles in the lungs

  • Heart sounds

    • Decreased breath sounds

    • Pericardial rub sound

++

Functional Implications

++

  • New York Heart Association functional status

    • Class I: a patient who is not limited with normal physical activity by symptoms

    • Class II: occurs when ordinary physical activity results in fatigue, dyspnea, or other symptoms

    • Class III: characterized by a marked limitation in normal physical activity

    • Class IV: defined by symptoms at rest or with any physical activity

  • Depending on the severity

    • Decreased activity tolerance

    • Decreased exercise tolerance

    • Dyspnea on exertion

    • Hypoxia

    • Muscle weakness

    • Cardiac arrhythmia

++

Possible Contributing Causes1

++

  • Infections

    • Viral infection: coxsackievirus

    • Bacterial infection: tuberculosis, purulent (staphylococcal, pneumococcal)

    • Fungal infection

    • Protozoal: ambiasis

    • Mycotic: actinomycosis, coccidiodomycosis

  • Collagen vascular disease

    • Systemic lupus erythematosus

    • Scleroderma

    • Rheumatoid arthritis

  • Heart attack

  • Medications: tetracyclines

  • Radiation

  • Trauma

  • Rheumatic fever

  • Metabolic

    • Kidney failure

  • Neoplasm: cancer

  • HIV infection

  • Idiopathic

  • Auto-immune (Dressler's syndrome)

++

Differential Diagnosis

++

  • Cardiac pump dysfunction

  • Angina pectoris

  • Aortic dissection

  • Aortic ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.