Péricardites aiguës et chroniques

Pericarditis refers to any inflammatory affection of the pericardium which is the heart serous envelop. The clinical expression of such lesions widely varies: acute types without intra-pericardial effusion (dry pericarditis), acute types with effusion (fluid pericarditis), recurrent pericarditis, and chronic types, calcific or fibrotic, with impaired ventricular filling (chronic constrictive pericarditis). The incidence of such diseases is low in comparison to that of other diseases such as coronary insufficiency; however, physicians must be aware of these clinical presentations since they may induce many problems, at different levels: diagnostic (an acute pericarditis mimicking a myocardial infarct, a chronic pericarditis mimicking a heart failure or a hepatic cirrhosis), etiologic (pericarditis as the sign of a serious or severe extracardiac affection), acute haemodynamic disorder (effusion-induced compression of the cardiac cavities with a cardiac tamponade presentation), chronic haemodynamic disorder (constrictive pericarditis), or therapeutic (multi-recurrent types). Diagnosis is primarily based on the three following simple non-invasive investigations: clinical examination, electrocardiography and combined cardiac Doppler and echocardiography.