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Perikarditt

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Definisjon:
Betennelse av perikard, oftest forårsaket av virusinfeksjon eller etter akutt hjerteinfarkt. Kan også forårsakes av systemsykdommer eller strålebehandling.
Forekomst:
Klinisk perikarditt er relativt sjelden, men funnet hos 1% i autopsimateriale
Symptomer:
Brystsmerter hos 95%, ofte intense og akutt innsettende, og kan stråle ut til skuldre, hals eller arm.
Funn:
Perikardiell gnidningslyd er typisk. Ved kronisk perikarditt kan det utvikles ødemer, halsvenestuvning og hepatomegali.
Diagnostikk:
EKG kan vise typiske forandringer. Ekko-kardiografi kan påvise perikardvæske og fortykket perikard. MR kan benyttes for å bestemme grad av inflammasjon i residiverende tilfeller
Behandling:
Akutt perikarditt behandles konservativt med observasjon og inflammasjonsdempende behandling, og ev. aktiv kausal behandling. Kirurgisk behandling aktuelt ved residiverende eller kronisk perikarditt.
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  • Ingard Løge, spesialist allmennmedisin, redaktør Norsk Elektronisk Legehåndbok (NEL)