Pericarditis (cont.)
How is pericarditis diagnosed?
Physical Evaluation
The doctor will assess:
- the quality of pain,
- what brings it on,
- what makes it better, and
- where it came on gradually or quickly and what other symptoms may be present.
The history gives direction as to what may be the cause of chest pain when the symptoms described above are noted.
The most common physical finding that almost always confirms the diagnosis is a pericardial friction rub. Fluid and inflammation in the pericardial sac causes a noise that can be heard with a stethoscope over the lower border of the sternum (the breastbone). It is sometimes better heard when the patient leans forward, which causes the heart to shift to the front of the chest. The rub may not always be present and may come and go from hour to hour.
Diagnostic Testing
The electrocardiogram (EKG or ECG) shows electrical activity of the heart. In pericarditis, there are often abnormalities that sometimes can help with the diagnosis. Unfortunately, many normal variants can mimic the changes in pericarditis or the EKG may be normal.
A chest x-ray may suggest enlargement of heart tissue and can be used to rule out other problems within the chest.
Echocardiography or ultrasound of the heart is often used to confirm the diagnosis. The cardiologist looks for the presence of fluid in the pericardial sac, although in many mild cases of acute pericarditis, there is no pericardial fluid seen with echocardiography.
Blood testing can be used to look for specific causes of pericarditis like infection, leukemia,
kidney failure, connective tissue diseases or thyroid abnormalities.
Next: What is the treatment for pericarditis? »
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