Uremic pericarditis is less common today due to the availability of dialysis but can occur in any patient with end-stage renal disease. The patient develops a serofibrinous or serosanguinous pericardial exudate.
Patient selection: end-stage renal disease, typically not receiving dialysis
Clinical features:
(1) chest pain that is relieved by leaning forward
(2) fever
(3) muffled heart sounds
(4) pericardial friction rub
(5) leukocytosis
(6) ECG changes (decrease wave amplitude, diffuse ST and T wave elevations, PR segment depression)
Complications:
(1) constrictive pericarditis
(2) cardiac tamponade
(3) hemopericardium
Indications for drainage:
(1) cardiac tamponade
(2) large effusion that fails to respond after 2 weeks of adequate dialysis
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