2020 Sep 16. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–.
The pericardium is the fibroelastic sac surrounding the heart. It is composed of two layers, visceral and parietal, that are separated by a "potential" space. Within this potential space, it is normal to have 15-50 mL of fluid to serve the purpose of lubrication. The term acute pericarditis refers to inflammation of this fibroelastic sac. The causes of pericarditis are wide ranging from infection, autoimmune processes, malignancy, and uremia. This article will discuss uremic pericarditis, including the etiology, epidemiology, pathophysiology, evaluation, and treatment. Uremic pericarditis typically occurs in patients with end-stage renal disease and patients with severe azotemia (elevated blood urea nitrogen, BUN), typically above 60 mg/dL. Clinical features of uremic pericarditis include chest pain, particularly in the recumbent position, a pericardial rub is often audible, and in severe cases, cardiac tamponade may be present. The diagnosis of uremic pericarditis is made by electrocardiogram which typically shows diffuse ST and T-wave elevations. Treating this condition is often by lowering BUN through dialysis.