uremic pericarditis

Introduction

Introduction to uremic pericarditis In the advanced stage of renal insufficiency, the incidence of uremic pericarditis is 40% to 50%, mostly fibrinous pericarditis, accompanied by bloody pericardial effusion. The occurrence of this disease is not directly related to the extent of azotemia. The general symptoms are mild, chest pain is mild, and the symptoms of pericarditis are often masked by uremia and other complications such as heart failure. Electrocardiogram changes are often atypical due to electrolyte disturbances or interference from digitalis drugs. Hemodialysis is an effective treatment and should be done as soon as possible. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: Chronic constrictive pericarditis

Cause

Causes of uremic pericarditis

The disease is a serious complication of chronic renal insufficiency, which can be divided into uremic pericarditis and pericarditis after dialysis.

Platelet function and coagulopathy (25%)

Patients with platelet function and coagulopathy, decreased fibrinolytic activity, leading to hemorrhagic pericarditis or hemorrhagic fibrous pericarditis, increasing the risk of cardiac tamponade.

Hyperthyroidism (20%)

If the patient suffers from hyperparathyroidism, a large amount of thyroid hormone is secreted, calcium salts are increased, and pericardium is deposited. Accompanied by volume overload, hyperuricemia, hypoproteinemia, etc. can also lead to pericarditis.

Toxic substances (10%)

Chemical inflammation of the capsule caused by toxic substances such as urea nitrogen.

Other factors (10%)

Malnutrition, immune function is low, frequent bacterial and viral infections easily spread to the pericardium, and the disease is induced.

Prevention

Uremia pericarditis prevention

Uremia heart disease is caused by a variety of factors, to improve its prognosis in addition to the cause of treatment, should use comprehensive treatment and preventive measures, a reasonable diet to supplement protein, essential amino acids with various vitamins, trace elements, etc. Helps improve heart function. For patients with edema, it is necessary to limit water and sodium, reduce volume load, emphasize low-fat diet, exercise properly to avoid uremic coronary artery disease, properly take lipid-lowering drugs to improve lipid metabolism, and correct Anemia, disorder of calcium and phosphorus metabolism, electrolyte imbalance, these measures are beneficial to improve the prognosis of uremic heart disease.

Complication

Uremia pericarditis complications Complications Chronic constrictive pericarditis

Cardiac tamponade can occur in this disease, and a few can develop subacute and chronic constrictive pericarditis.

Symptom

Urinary pericarditis symptoms common symptoms heart failure pericarditis precordial painful dyspnea acute hemolytic uremic syndrome pericardial fiber thickening tachycardia pericardial effusion pericardial effusion low blood pressure

Urinary pericarditis has obvious symptoms only 6% to 17%, the symptoms of pericarditis are often covered by uremia and other complications, such as heart failure, patients often have persistent precordial pain, lying and deep breathing When it is intensified, it is often diagnosed by hearing the pericardial friction sound. Fever and a large amount of pericardial effusion are more common in "dialysis-related pericarditis", which is characterized by tachycardia and difficulty in breathing; hypotension can also occur during dialysis. Acute circulatory dysfunction, physical examination of the anterior region of the heart can be heard and rough pericardial friction sounds or sputum and friction, can have varying degrees of pericardial fluid signs.

Examine

Urinary pericarditis

Laboratory tests: Laboratory tests can have anemia, water, electrolyte imbalance, and acid-base balance disorders associated with uremia patients.

Auxiliary inspection:

1. Echocardiography can show pericardial effusion.

2. Diagnostic pericardial puncture and therapeutic puncture drainage, it can be seen that the pericardial effusion is generally aseptic serous fibrin or bloody exudate, and the exudate in the "dialysis-related pericarditis" center is often serous and bloody.

Diagnosis

Diagnosis and diagnosis of uremic pericarditis

In patients with uremia, if you hear pericardial friction in the anterior region, the diagnosis of uremia pericarditis can be determined.

Diagnosis of this disease requires the exclusion of other inflammation of the pericardium, such as purulent, tuberculous pericarditis, etc., purulent, tuberculous pericarditis caused by the primary disease, such as tuberculosis can have hot flashes in the afternoon, night sweats. Suppurative pericarditis can have chills, high fever, and sweating. Diagnosis can be made based on the cause, clinical manifestations, and laboratory tests. Exclude and determine if there is uremic myocarditis. Chemical

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