CAUSES :
1. INFECTIOUS :
- VIRAL : COXSACKIEVIRUS, HEPATITIS A & B, HIV
- PYOGENIC
- TUBERCULAR
- FUNGAL : HISTOPLASMOSIS, COCCIDIOIDOMYCOSIS
- OTHER: SYPHILIS, PROTOZOAL, PARASITIC
2. NONINFECTIOUS
- ACUTE IDIOPATHIC
- UREMIA
- PULMONARY EMBOLISM
- HYPOTHYROIDISM
- NEOPLASIA
- MYXEDEMA
- AC MYOCARDIAL INFARCTION
- POST IRRADIATION
- AORTIC DISSECTION
- TRAUMA
- CHOLESTEROL
- CHYLOPERICARDIUM
- FAMILIAL MEDITERRANEAN FEVER
- WHIPPLE DISEASE
- SARCOIDOSIS
3. HYPERSENSITIVITY OR AUTOIMMUNITY RELATED :
- RHEUMATIC FEVER
- COLLAGEN VASCULAR DISEASE : SLE, RHEUMATOID ARTHRITIS, ANKYLOSING SPONDYLITIS, SCLERODERMA, WEGENER GRANULOMATOSIS, POLYARTERITIS NODOSA
- DRUG INDUCED : PROCAINAMIDE, HYDRALAZINE, ISONIAZID, MINOXIDIL, PHENYTOIN, ANTICOAGULANTS, METHYSERGIDE, ANTHRACYCLINES, BETA LACTAM ANTIBIOTICS
- POST CARDIAC INJURY
- DRESSLER SYNDROME
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D.D. :
- CARDIAC TAMPONADE
- CARDIOMYOPATHY, DILATED
- MYOCARDIAL INFARCTION
- MYOCARDIAL ISCHAEMIA
- PERICARDITIS, ACUTE
- PERICARDITIS, CONSTRICTIVE
- PERICARDITIS, CONSTRICTIVE, EFFUSIVE
- PERICARDITIS, UREMIC
- PULMONARY EDEMA, CARDIOGENIC
- PULMONARY EMBOLISM
OTHER TESTS :
* ECG - WIDESPREAD ELEVATION OF ST SEGMENT WITH UPWARD CONCAVITY WITH RECIPROCAL DEPRESSION IN ONLY AVR & V1.
* IN SMALL EFFUSIONS TWO DIMENTIONAL TRANSTHORACIC ECHOCARDIOGRAPHY
* MRI - MAY DETECT AS LITTLE FLUID AS 30 ML & ABLE TO DISTINGUISH HAEMORRHAGIC OR NONHAEMORRHAGIC EFFUSION.
* SERUM ELCTROLYTES- FOR METABOLIC ABNORMALITIES
* CARDIAC ENZYMES LIKE CPK-MB, TROPONIN
* THYROID FUNCTION TEST
* RA FACTOR, IMMUNOGLOBULIN COMPLEXES, ANA & COMPLIMENT LEVELS - IN SUSPECTED RHEUMATOLOGIC CAUSES
* ESR - ELEVATED
* MODERATE GRANULOXYTOSIS OR LYMPHOCYTOSIS
* TROPONIN I OR TROPONIN T TEST - POSITIVE IF SOME MYOCARDIAL INVOLVEMENT IS PRESENT
* PERICARDIOCENTESIS
* PERICARDIAL BIOPSY