How to Diagnose Pericarditis

The pericardium is a sac-like membrane that surrounds the heart and is composed of 2 layers: the parietal pericardium, which is the outer fibrous layer and the visceral pericardium which is a thin serous layer. Pericarditis is an inflammation of either or both of these layers. The following steps explain how to diagnose pericarditits.

Instructions

• 1

  Consult wih your physician who will determine what tests you may need. Medical professionals are the only ones who can find out if you have pericarditis. They will do a clinical exam and workup.

• 2

  Obtain the patient history. The cardinal symptom of pericarditis is chest pain, which may be aching, burning, dull, pressing or sharp. The pain can range from mild to severe but worsens when inhaling, lying flat or swallowing. Fever and breathing difficulty may also be present.

• 3

  Using a stethoscope, listen to the pericardial friction rub that frequently allows a diagnosis to be made for acute pericarditis. The pericardium makes a scratching sound like leather rubbing on leather and is best heard by placing the stethoscope over the left lower sternal edge.

• 4

  Perform an echocardiography as the procedure of choice when pericardial effusion is suspected. The M-mode should show a persistent echo-free space between the epicardium and pericardium but this may also be caused by epicardial fat, pleural effusion or a pericardial mass.

• 5

  Take a chest x-ray. A large pericardial effusion may be indicated by an enlarged cardiac silhouette shaped like a flask. Effusions smaller than a few hundred ml may have a normal silhouette.

• 6

  Monitor the 4 stages of acute pericarditis with electrocardiography. Stage 1 begins with an upward ST elevation, stage 2 is marked by a return of the ST segment to baseline, the T waves become inverted in stage 3 and return back to the baseline in stage 4.