Acute inflammation of the visceral and mural layers of the pericardium is known as acute pericarditis. Acute pericarditis is caused by one of the secondary systemic diseases. The clinical manifestations of acute pericarditis are non-specific, tuberculosis, rheumatic, as well as those caused by myocardial infarction, uremia and tumors, etc. With the widespread use of antibiotic drugs, the bacterial and rheumatic nature of acute pericarditis has been significantly reduced, while acute non-specific pericarditis is gradually increasing. The main reason for this is that it is not a good idea to use a lot of money. Etiology 1, tuberculosis: Most often seen in children and young people, often from pulmonary tuberculosis, mediastinal lymphatic tuberculosis and pleural tuberculosis spread directly, or from blood and lymphatic dissemination. Etiology 2, septic: often secondary to sepsis or septicemia, bacterial invasion of the pericardium by blood or lymph. Cause 3, viral: Coxsackie virus, influenza virus (type A and B), and echovirus are more common. Etiology 4, fungal: podocyte histoplasmosis is more common. Etiology 5, parasitic: amoeba-induced left lobe liver abscess often penetrates into the pericardium and acute pericarditis occurs. The symptoms of acute pericarditis are analyzed: mild cases can be asymptomatic, so it is easy to be ignored, but generally show the following performance. In infectious pericarditis, there are toxic symptoms such as fever, chills, excessive sweating, drowsiness, and loss of appetite. In non-infectious pericarditis, the toxemia symptoms are milder, and in tumorigenic cases, there may be no fever. Symptom 2, precordial pain: mainly seen in the fibrinous pericarditis stage. The pain is located in the precordial region or behind the sternum, and may also disperse to the left arm, left shoulder, left scapular region, or upper abdomen. The pain is sharp and severe or heavy and dull, and can be aggravated by breathing, coughing, swallowing and position changes. Symptom 3, pericardial effusion compression symptoms: In the case of pericardial tamponade, epigastric distension, vomiting and swelling of lower limbs may occur due to vena cava stasis, and pulmonary stasis may cause respiratory distress. When the arterial blood pressure drops significantly, shock symptoms such as pallor and irritability can be seen. The diagnosis of acute pericarditis: 1. Laboratory tests: white blood cell count increases or not, depending on the cause, and in septic pericarditis the white blood cell count and neutrophils are significantly higher. 2.X-ray examination: In adults with pericardial effusion of less than 300ml, there are few X-ray signs, which are difficult to detect. When the effusion is 300-500ml or more, the heart shadow only appears to be universally enlarged to both sides, and the morphology of the heart shadow may change depending on the position. 3.Echocardiography: When the amount of pericardial fluid accumulation exceeds 50ml, M-type echocardiography shows that there is a liquid dark area between the posterior wall of the left ventricle and the posterior pericardial wall layer during ventricular contraction. 4.Electrocardiogram: In acute pericarditis, because the inflammation often affects the subepicardial myocardium, there are extensive myocardial injury type electrocardiogram changes, typically early, except for the AVR leads. 5.Nuclear scan: Intravenous injection of 125-labeled albumin for blood pool scanning. If the heart shadow in the radiograph is larger than the scan, the enlarged portion is an exudate. The treatment of acute pericarditis: 1. The principles are: treat the primary disease, improve the symptoms, and relieve circulatory disorders. 2, general treatment: the acute stage should be bed rest, respiratory distress in a semi-recumbent position, oxygen, chest pain can be given analgesics, if necessary, codeine or dulcolax. Strengthen supportive therapy. 3, etiological treatment: anti-TB treatment is given for tuberculous pericarditis, the medication and course of treatment are the same as for tuberculous pleurisy, and prednisone 15-30mg daily can also be added to promote the absorption of exudate to reduce adhesions. Rheumatic patients should strengthen anti-rheumatic treatment. 4, lifting the pericardial filling: a large amount of exudate or symptoms of pericardial filling, can perform pericardiocentesis to convulse fluid decompression.