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Endocardium, myocardium, pericardium

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Q: If a person has endocarditis myocarditis or pericarditis what areas in order are infected?
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Generally, treatment is conservative if the patient is young and otherwise healthy. An echocardiogram will frequently be performed at some point to ensure there is not a large pericardial effusion that needs to be drained. If the patient has a chronic autoimmune disease, such as Rheumatoid arthritis or Lupus erythematosus, pericardial effusions along with pericarditis are more common. If the person is elderly, or has a history of prior malignancy, more of a workup may be undertaken to ensure the pericarditis is not actually a manifestation of a metastatic lesion.For uncomplicated pericarditis, frequently caused by a viral infection, the treatment is rest and nonsteroidal analgesics, such as ibuprofen or indomethacin. For other causes of pericarditis, the underlying cause must be treated.Answer:Diagnosis of pericarditis:EchocardiogramEKGElevated white blood cell countElevated sedimentation rateElevated C-Reactive Protein or CRPCardiac enzymes are evaluated for myocarditis or myocardial infarction, troponin is elevated in some patientsEvaluate thyroid functionChest x-rayMRITreatment:Bed restHigh dose non-steroidal analgesics, such as ibuprofen (Advil and Motrin). Typical dose is 600 mg two to four times a day depending on the severity of the condition.Colchicine 1 - 2 tablets/dayIf the ibuprofen and colchicine are used together, the chances of a recurrence are lessened.Hospitalization maybe necessary if complications of pericarditis exist such as pericardial effusion and atrial fibrillation.


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