Síntomas y diagnóstico de la pericarditis

 man grabbing chest

Signs and symptoms of pericarditis

Un síntoma habitual de pericarditis aguda es un dolor torácico agudo y punzante, que suele aparecer rápidamente. A menudo, se manifiesta en la parte central o izquierda del pecho, y puede sentir dolor en uno o en ambos hombros.

Sentarse e inclinarse hacia delante tiende a aliviar el dolor, mientras que tumbarse y respirar profundo lo empeoran. Algunas personas describen el dolor como una presión o un dolor sordo en el pecho.

El dolor torácico puede parecerse al de un ataque cardíaco. Si tiene dolor torácico, llame al teléfono de emergencias inmediatamente, porque es posible que esté sufriendo un ataque cardíaco.

Fever is another common symptom of acute pericarditis. Other symptoms are weakness, trouble breathing and coughing. Palpitations, which are feelings that your heart is skipping a beat, fluttering or beating too hard or too fast, may occur and can be a sign of deeper heart tissue involvement.

Chronic pericarditis often causes tiredness, coughing and shortness of breath. Chest pain is sometimes absent with this type of pericarditis. Severe cases of chronic pericarditis can lead to swelling in the stomach, feet, ankles and legs and hypotension (low blood pressure).

Complications of pericarditis

Dos complicaciones graves de la pericarditis son el taponamiento cardíaco y la pericarditis constrictiva crónica.

  • Cardiac tamponade happens if too much fluid collects in the sac, putting pressure on the heart. This prevents the heart from properly filling with blood, so less blood leaves the heart, causing a sharp drop in blood pressure. Untreated cardiac tamponade can be fatal.
  • La pericarditis constrictiva crónica es una enfermedad poco frecuente que tarda tiempo en desarrollarse. Provoca la formación de tejido cicatricial en todo el saco que rodea el corazón. A medida que el saco se vuelve rígido y no se puede mover correctamente, el tejido cicatrizado empieza a comprimir el corazón y evita que funcione como debe hacerlo.

Diagnosing pericarditis

A doctor diagnoses pericarditis based on your medical history, a physical exam and test results.

Specialists involved

Primary care doctors, such as a family doctor, internist or pediatrician, often diagnose and treat pericarditis. A cardiologist, pediatric cardiologist or infectious disease specialist may be involved, depending on the patient’s age and medical conditions.

Medical history

Su médico puede preguntarle si tuvo:

  • Una infección respiratoria reciente o una enfermedad similar a la gripe
  • Un ataque al corazón o una lesión en el pecho recientes
  • Other medical conditions

If you have chest pain (angina), your doctor will ask you to describe how it feels, where it's located and whether it's worse when you lie down, breathe or cough.

Exploración física

When the pericardium is inflamed, the fluid between the sac's two layers of tissue increases. So your doctor will look for signs of excess fluid in your chest. A common sign is the pericardial rub. This is the sound of the pericardium rubbing against the outer layer of your heart. Your doctor will listen for this using a stethoscope.

El médico puede oír otros sonidos del pecho que son signos de líquido en el pericardio (derrame pericárdico) o en los pulmones (derrame pleural). Ambos son problemas más graves relacionados con la pericarditis.

Pruebas diagnósticas

El médico puede recomendarle hacerse más pruebas para diagnosticar su afección y su gravedad. Las pruebas más habituales son las siguientes:

  • EKG (electrocardiogram): This detects and records your heart's electrical activity, with certain EKG results suggesting pericarditis.
  • Chest X-ray: A chest X-ray takes pictures of the inside of the chest, including your heart, lungs and blood vessels. The pictures can show whether you have an enlarged heart, which can be a sign of excess fluid in your pericardium.
  • Echocardiography (PDF): This test uses sound waves to create pictures of your heart, showing its size and shape and how well it's working. It can show fluid build-up in the pericardium.
  • Cardiac CT (computed tomography): This X-ray takes a clear, detailed picture of your heart and pericardium and helps to rule out other causes of chest pain.
  • Cardiac MRI (magnetic resonance imaging): A cardiac MRI uses magnets and radio waves to form detailed pictures of your organs and tissues. It can show changes in the pericardium.

    Your doctor also may recommend blood tests to find out if you've had a heart attack, the cause of your pericarditis and the extent of inflammation in your pericardium.

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