1. Study the text “Pericarditis”. Read the passage dealing with the etiology of disease and express its content in 3-4 sentences.

2. Find and translate in a written form the passage dealing with the inspection of patients suffering pericarditis.

3. Convey the main idea of the text using the following models:

1) It is known that…

2) It should be noted that…

3) It is generally recognized that…

4) The following conclusions are drawn…

Pericarditis

The main cause of acute pericarditis is an infection, particularly rheumatic fever. It may be a direct extension of inflammation from the surrounding organs or through the blood stream in general septic processes. Of the acute forms, the suppurative is the most serious type; it develops as a sequel to conditions as pneumonia, empyema, or septicemia. Often the acute fibrinous or serofibrinous types develop and run a comparatively benign course, terminating with complete resolution without the true condition being recognized or diagnosed. Frequently the general infection of the preexisting disease may be so severe that the pericardial lesion is completely overlooked.

It must be kept in mind that acute coronary thrombosis may be an immediate cause of acute pericarditis, but in this case the true nature of the underlying lesion is usually recognized. Tuberculosis too is a very common cause of pericarditis.

The chief symptom of pericarditis is precordial distress. The pain is seldom severe in nature, but usually takes the form of a dull aching sensation over the lower portion of the sternum, which is made worse by pressure on the sternum. Rapid pulse, fever, and an increased respiratory rate are practically always present. After the pain has persisted for a day or two, it often becomes less and less, and finally disappears entirely. Freedom from precordial pain is usually followed by distressful dyspnea.

When the pain gives way to shortness of breath, it is usually a sign that the precordial effusion has become great enough to separate parietal from the visceral layers of the pericardial sac which relieves the pain. The effusion may be mild, moderate, or severe, and the degree of dyspnea is usually dependent upon the amount of effusion. Usually dyspnea lasts for a few days and then disappears. However, this does not mean that the effusion has ceased, since it may persist for a much longer time.

Ordinarily the effusion completely vanishes within a period of a week or ten days, although sometimes suppuration may set in, which precipitates a serious complication. With the disappearance of the effusion, the half-forgotten pain of the earlier stage may return to some degree, together with the classical pericardial friction rub.

On inspection one usually finds some characteristic features of acute pericarditis. The patient with an acute rheumatic infection who has been progressing fairly well, let us say, becomes more restless than usual, the temperature rises to a higher point, the pulse increases in rate, and sometimes a dusky cyanotic tinge appears. Palpation of the precordial area may reveal fremitus friction. On percussion in the early stages no abnormality is found. Auscultation brings out the characteristic to-and-fro friction rub that is not synchronous with either the systolic or diastolic phases of the heart rhythm.