Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Seyed-Ali Sadjadi, Ardavan Mashahdian
Jerry L. Pettis Memorial Veterans Medical Center, Loma Linda University School of Medicine, Loma Linda, CA, USA
Am J Case Rep 2015; 16:169-173
Uremic pericarditis, common at one time among dialysis patients, has become a rare entity in recent years. Due to its low incidence, its recognition has gained importance among internists, cardiologists, and nephrologists. It can be seen in predialysis patients and in dialysis patients who are on hemodialysis or peritoneal dialysis.
Case Report: We report 3 cases of uremic pericarditis and their presenting manifestations and review 30 cases we have treated. Among these patients, the traditional findings among patients with acute pericarditis such as chest pain, fever, electrocardiographic changes, and leukocytosis are uncommon. Pericardial friction rub has a relatively high incidence but its differentiation by an untrained ear, especially by a non-cardiologist, could be a major problem. Not infrequently, it is complicated by pre-tamponade or tamponade, requiring pericardiocentesis or pericardial surgery.
Conclusions: Uremic pericarditis is a treatable, but not always a preventable, condition. Timely recognition of its presence and its efficient management are essential elements of successful treatment.
Keywords: Coronary Artery Disease - complications, Diabetes Complications, Diagnosis, Differential, Heart Failure - complications, Hypertension - complications, Kidney Failure, Chronic - complications, Pericardial Effusion - therapy, Pericardiocentesis, Pericarditis - therapy, Renal Dialysis - methods, Risk Factors, Uremia - complications