Uremic pericarditis history and symptoms

Patients with pericarditis commonly present with chest pain that changes with position, cough, fever, breathlessness, and fatigue are the other common symptoms. Less common symptoms include palpitations, hiccup, odynophagia, faint, dizziness, and abdominal pain which is seen mostly in children.

• The majority of patients with uremic pericarditis are asymptomatic due to its slow progression.
• The hallmark of uremic pericarditis is chest pain which worsens on leaning forward and inspiration. A positive history of End-stage renal disease , chest pain and fever of unknown origin is suggestive of uremic pericarditis. The most common symptoms of uremic pericarditis include chest pain which worsens on leaning forward and inspiration.

Patients with uremic pericarditis may have a positive history of:^[1]

• End stage renal disease
• Chest pain
• Fever of unknown origin

Common symptoms of pericarditis include:^{[2][3][4][5][6][1]}

• Chest pain that improves on leaning forward and worsens on inspiration Chest pain is the most common symptom.
  • Causes of pain include inflammation of the pericardium, phrenic nerves, and the nearby pleura.
  • The pain is often initially sharp in nature, but it can be described as sticking, dull, aching, or pressure-like.
  • Deep inspiration and cough can increase the pain so that the patient may sit upright for relief.
• Cough (either dry or productive)
• Fever
• Fatigue
• Anxiety
• Breathlessness
• Malaise

Less symptoms of pericarditis include:^[7][8]

• Pain along the trapezius ridge(s), when present is very characteristic of pericarditis. The pain of myocardial infarction tends to involve the anterior precordium with radiation to the left arm.
• Palpitations
• Hiccup (rarely)
• Ankle edema
• Odynophagia with or without dysphagia
• Faintness and dizziness (uncommon unless cardiac tamponade is present)
• Abdominal pain (particularly in children)

Uremic pericarditis develops more slowly and can be undetectable until it presents as a fever of unknown origin.^[9][10]

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