Pancarditis

Pancarditis is an inflammation of all layers of the heart (endo-, myo - and pericardium). Occurs pancarditis with rheumatism, scarlet fever, sepsis, especially gonococcal. It occurs more often in children and young age. Manifested systolic noise at the top, tachycardia, changes in the electrocardiogram, etc. Often develops severe cardiac failure (see Circulation, circulatory insufficiency). Treatment of pancarditis comes to the treatment of the disease, causing pancarditis, and heart failure. Cm. also, Myocarditis, Pericarditis, Endocarditis.

Pancarditis (pancarditis; from the Greek. pan - whole and kardia - the heart - is an inflammation of all layers of the heart (endo-, myo - and pericardium). The causes of pancarditis most often rheumatism, scarlet fever, gonococcal septicopyemia. P. occurs usually at a young age, especially for children.
Pancarditis rheumatic etiology develops more often recurrence of rheumatic heart disease in patients with existing heart disease in cases of rapid disease. Accession exudative pericarditis (see) to endomyocarditis (see Endocarditis) leads to a sharp deterioration, increase of heart failure, temperature rise. The disease is hard. Sharp pain in the heart, pain in the abdomen, repeated vomiting. Shortness of breath at rest, the position of orthopnea. Pale cyanotic color of skin. Borders of heart greatly expanded, tone deaf. The top and left edge of a breast bone heard (unstable) noise pericardial friction. The pulse is a fast, small filling. Blood pressure is reduced, venous increased. The liver is enlarged. Significant swelling. ECG - decreasing of voltage of all teeth. Radiographically - spherical or triangular configuration heart. Expressed situation of heart failure caused by fluid in the pericardium cavity and myocardial damage. Mortality in rheumatoid pancarditis in the prewar years, reached 50%, now much smaller, but the prognosis for P. always serious.
Septic pancarditis different severity General condition of the patient, large swings in temperature during the day, chills, sweats, enlargement of the spleen.
Treatment. Rheumatic pancarditis-strict bed rest, good nutrition, especially fresh vegetables, fruits, vitamins C, B1, R, heart failure, fluid restriction and salt. Drug - complex Antirheumatic means in various combinations: drugs salicylic acid - salitsilovaya sodium 6-10 grams per day, acetylsalicylic acid 4-6 g / day; pyrazolinone drugs-amidopirina 2-2,5 grams per day, analgin 2-3 g per day, phenylbutazone 0.45-0.6 grams per day. Hormone therapy with a gradual reduction of dosage: cortisone 100-200 mg per day, prednisolone 15-20 mg, triamcinolon 12-16 mg dexamethasone 1,5-2 mg Antibiotics : penicillin 600-800 thousand UNITS per day. Heart glycosides - strofantin 0,05% - 0,5 ml intravenously, korglykonum 0,06% - 1 ml intravenously. Diuretics - gipotiazid 50-100 mg / day, novoryt 1-2 ml Camphor 20% - 2 ml, caffeine 10% - 1 ml of Oxygen therapy.
In septic pancarditis apply penicillin in high doses - time from 250 to 400 thousand UNITS, the daily 1,5-2 million UNITS (purulent exudate by injection directly into the pericardial cavity). When significant serous effusion and the threat of cardiac tamponade - puncture of the pericardial and removal of the fluid. In chronic constrictive pericarditis the, mediastina-pericarditis - surgery (decorticate, Cardiris).
Prevention P. - see Rheumatism.