Acute pericarditis in young adults

Abstract

1. 1. Forty-six cases of pericarditis occurring among young soldiers have been presented. In 25 cases, rheumatic fever was the etiological factor; in 15 cases, no definite etiology was determined; and in 6 cases, various etiological factors were present. 2. 2. In this series of cases, the important points in the differentiation of acute pericarditis due to rheumatic fever from acute pericarditis of undetermined etiology were coincident joint manifestations and leucocytosis in the former, and the abrupt, severe onset and absence of leucocytosis in the latter. 3. 3. The electrocardiographic patterns in 43 cases of acute pericarditis have been reviewed. Elevation of S-T segments occurred in 60 per cent of the cases in which electrocardiograms were taken within the first ten days after the onset of pericarditis. In all but two cases, T-wave changes of the distinctive pattern of pericarditis were present. The electrocardiograms returned to normal in four days to seventeen weeks. In eight (30 per cent) of 29 cases in which serial electrocardiograms were studied, normal tracings were obtained after the onset of pericarditis and prior to the appearance of changes in the T waves. This indicates the need for taking electrocardiograms over a period of three to six weeks following the onset of clinical symptoms. No difficulty was encountered in differentiating the electrocardiographic patterns of pericarditis from those of myocardial infarction or of rheumatic fever without pericarditis. 4. 4. The differential diagnosis of acute nonrheumatic pericarditis and acute myocardial infarction has been discussed, and particular reference has been made to the difference in the electrocardiographic patterns produced by the two diseases.