Today - Cancer

[posey]

Well it is after midnight so now it is today that I will find out if I have lung cancer.

When I had the chest CAT Scan in Dec 2010, that is when they found the Pulmonary Embolism to add the already existing DVT in my left leg.

When they found the PE, they also found what they called a granuloma; to me it's another word for "too small to tell anything yet and get her back in 6 months".

However, I did find an article where a fungus can cause this also and then also cause the heart attack like pain I have been getting for 15 years. It is so bad I have to have med. under my tonguje to kill the pain. I foget what it is called and too late to look up in my docs.

I hope I can come back with good news.

posey

[Janice]

We will be waiting to hear whats going on. Is any one going with you to the docs?

[hellalone]

I hope you get the best possible results from your tests. Please let us hear how you are doing.

Take care, hella

[MeToo]

Wow Posey. I'm really sorry to hear the news and am hoping it's nothing to worry about. I hate the wait and see too.

[posey]

Thank you all.

I found the articles about fungus and granlomas.

!- Granuloma, fungal (majocchi's)

A nodule is usually a small, round shadow seen on chest x-ray anywhere in the lungs. Nodules are due to infections, inflammation, or tumors. A granuloma
Granuloma, fungal (majocchi's)
Subacute thyroiditis
Chalazionis a small cluster or nodule of inflammation that can occur in any area of the body, including the lungs. If this inflammation leaves behind a scar this is also called a granuloma. This inflammation could be due to an infection. Both nodules and granulomas are common in certain parts of the United States. Fungal infections are a common cause of nodules and granulomas in the mid-west due to Histoplasmosis and in the southwest due to Coccidioidomycosis also called valley fever.

Since tumors can be one cause of nodules and granulomas they are generally checked periodically over time to be sure that they are staying the same. When there is change the goal is to notice the change early so that further testing can be done. Then treatment can be started as soon as possible when it will be most helpful. So your doctors recommendation of another CT scan in 6 months is sound practice.

If the granuloma nodule is clearly visible on the chest x-ray, a repeat chest x-ray in 6 months would be all that is needed. However if the granuloma nodule is not clearly visible on the chest x-ray, a repeat chest CT scan would be needed. There is certainly less radiation exposure with a chest x-ray than with a chest CT scan. However, a chest CT scan is more sensitive and shows more detail than a chest x-ray. Its possible to notice slight changes in the granuloma nodule with a chest CT scan. These slight changes may be missed with a chest x-ray.

As you can see this really comes down to a matter of the risk of radiation exposure compared with the benefit of finding changes in the granuloma nodule early. For more specific information about the risk versus the benefit, please check with the radiologist responsible for radiation safety at the location where you would have this testing done. This would be the best specialist to answer your question of exceeding healthy radiation exposure limits.
lung granuloma CT scan - Respiratory Disorders - MedHelp

[posey]

Histoplasmosis is an infection transmitted by airborne spores that you breathe in when you work in or around soil that contains a fungus called Histoplasma capsulatum. It generally affects your lungs, but may spread to other organs or tissues outside your lungs.
Farmers, landscapers, construction workers and people who have contact with bird or bat droppings are especially at risk of histoplasmosis.
Most people with histoplasmosis never develop symptoms and aren't aware they're infected. But for some people — primarily infants and those with compromised immune systems — histoplasmosis can be serious. Effective treatments are available for even the most severe forms of histoplasmosis

Symptoms
By Mayo Clinic staff
Several types of histoplasmosis exist, ranging from mild to life-threatening. The mildest form produces no signs or symptoms, but severe infections can cause serious problems throughout your body as well as in your lungs. When signs and symptoms do occur, they usually appear three to 17 days after exposure.
Asymptomatic primary histoplasmosis
This is the most common form of histoplasmosis and usually causes no signs or symptoms in otherwise healthy people who become infected. The only sign that you were ever infected may be small scars in the lungs.
Acute symptomatic pulmonary histoplasmosis
This form of histoplasmosis tends to occur in otherwise healthy people who've had intense exposure to H. capsulatum. Because the severity of the disease depends on the number of fungus spores inhaled, reactions may range from a brief period of not feeling well to serious illness. Typical signs and symptoms include:
Fever
Muscle aches
Headache
Dry cough
Chills
Chest pain
Loss of appetite
Sweats
In some cases, the following may also accompany acute symptomatic pulmonary histoplasmosis:
Arthritis.
Inflammation of the sac that surrounds the heart (pericarditis).
Severe acute pulmonary syndrome, a potentially life-threatening condition in which breathing becomes difficult. Also called spelunker's lung, this often occurs after prolonged exposure to bat excrement stirred up by explorers in caves.
Arthritis and pericarditis don't mean that the infection has spread outside your lungs. Instead, they develop because your immune system responds to the fungus with an unusual amount of inflammation.
Chronic pulmonary histoplasmosis
This type of histoplasmosis usually affects people with an underlying lung disease, such as emphysema. The disease is chronic and if left untreated may progress to disabling lung problems. Signs and symptoms include:
Fever
Night sweats
A cough that may bring up blood
Shortness of breath
Weight loss
Disseminated histoplasmosis
Occurring primarily in infants and people with compromised immune systems, disseminated histoplasmosis can affect nearly any part of your body, including your eyes, liver, bone marrow, central nervous system, skin, adrenal glands and intestinal tract. Untreated disseminated histoplasmosis is usually fatal. Depending on which organs are affected, people with this form of the disease may develop:
Fever
Weight loss
Enlarged spleen
Enlarged liver
Pneumonia
Inflammation of the sac surrounding the heart (pericarditis)
Inflammation of the thin membrane that covers the brain and spinal cord (meningitis)
Poorly functioning adrenal glands (adrenal insufficiency)
Ulcers of the mouth, tongue or intestinal tract
When to see a doctor
Contact your doctor if you live in an area where histoplasmosis is common — such as the Ohio and Mississippi river valleys of North America — and you develop chest pain, cough and a fever. Although many illnesses cause similar signs and symptoms, your doctor may want to test you for the presence of H. capsulatum. If your immune system has been weakened by illness or medications, and you develop any symptoms of histoplasmosis, seek medical care immediately.

Causes
By Mayo Clinic staff


Histoplasmosis is caused by the reproductive cells (spores) of the fungus Histoplasma capsulatum. The spores are extremely light and float into the air when dirt or other contaminated material is disturbed.
Histoplasmosis and your lungs
Because the spores of H. capsulatum are microscopic in size, they can easily enter your lungs and settle in the small air sacs. There, the spores are trapped by macrophages — immune system cells that attack foreign organisms. The macrophages carry the spores to lymph nodes in your chest, where they continue to multiply. This may lead to inflammation, scarring and calcium deposits. In cases of heavy infection, the lymph nodes may become so enlarged that they obstruct your esophagus or your lungs' airways.
Most often, however, you're not likely to have noticeable signs and symptoms, and the infection clears on its own without treatment. But if your immune system isn't able to eliminate the spores, they can enter your bloodstream and travel to other parts of your body. In that case, you may develop a variety of severe problems that can be fatal if not diagnosed and treated quickly.
Even if you've had histoplasmosis in the past, you can still get the infection again. However, if you contract histoplasmosis again, the illness will likely be milder than the initial infection.
Where the fungus lives
Histoplasma capsulatum is primarily found in the temperate regions of the world. It's very common in the Ohio and Mississippi river valleys of North America, where many people have already been exposed to the fungus.
It thrives in damp soil that's rich in organic material, especially the droppings from birds and bats. For that reason, it's particularly common in chicken and pigeon coops, old barns, caves and parks.
Birds themselves aren't infected with histoplasmosis — their body temperature is too high — but they can carry H. capsulatum on their feathers, and their droppings support the growth of the fungus. Birds commonly kept as pets, such as canaries and parakeets, aren't affected. And although bats, which have a lower body temperature, can be infected, you can't get histoplasmosis directly from a bat or from another person.

[posey]

Risk factors
By Mayo Clinic staff
Anyone exposed to H. capsulatum is likely to become infected. People who inhale a huge number of spores — those who work with heavily infected soil or have close contact with bat droppings, for example — are more likely to develop signs and symptoms.
Most at risk of infection
Farmers
Pest control workers
Poultry keepers, especially when cleaning chicken coops, pigeon roosts, and bat-infested barns or lofts
Construction workers, especially those who work around old buildings with roosting birds
Roofers
Landscapers and gardeners
People involved in building roads and maintaining bridges
People who monitor bird populations or who have contact with bats or bat caves
Archeologists
Geologists
Most at risk of severe infection
Because their immune systems are weakened, the following people are most likely to develop disseminated histoplasmosis, the more serious form of the disease:
Infants and very young children
Older adults
People with HIV or AIDS
People receiving chemotherapy or long-term treatment with corticosteroid drugs such as prednisone
People who have had organ transplants and are taking anti-rejection medications

Complications
By Mayo Clinic staff
Histoplasmosis can cause a number of serious complications, even in otherwise healthy people. For infants, older adults and people with compromised immune systems, the potential problems are often life-threatening.
Enlarged lymph nodes. Most people with histoplasmosis have some involvement with the lymph nodes in the central part of the chest. This region lies between your lungs and contains the trachea, esophagus, heart and many small lymph nodes. In a small percentage of people with acute pulmonary histoplasmosis, the lymph nodes may enlarge enough to obstruct the airways or esophagus, making it difficult to breathe or swallow. Sometimes the pulmonary arteries and veins — the large blood vessels in the lungs — also may be blocked.
Severe scarring. A rare, severe late complication of histoplasmosis called fibrosing mediastinitis occurs when scar tissue from lymph nodes in the chest invades and blocks adjoining structures, especially the esophagus and large blood vessels. Signs and symptoms, such as a cough that brings up blood, chest pain and breathlessness, usually don't appear until the disease is quite advanced. When structures in both lungs are affected, fibrosing mediastinitis can be life-threatening.
Heart problems. Inflammation of the pericardium, the sac that surrounds your heart, is called pericarditis. Normally, this sac contains a small amount of fluid. But when the pericardium becomes inflamed, the amount of fluid in the sac may increase, which can interfere with the heart's ability to pump blood efficiently. Pericarditis that occurs as a complication of histoplasmosis usually results from inflammation in nearby lymph nodes, rather than from actual infection of the pericardium itself.
Arthritis. Joint inflammation, sometimes in conjunction with a skin rash (erythema nodosum), is a common complication of acute pulmonary histoplasmosis. Women are far more likely to be affected than are men.
Adrenal insufficiency. Your adrenal glands, which are located just above your kidneys, produce hormones that give instructions to virtually every organ and tissue in your body. A histoplasmosis infection can cause destruction of the adrenal glands. When the glands don't provide enough of these hormones, serious, and potentially life-threatening, problems can occur. Untreated adrenal insufficiency (Addison's disease) is fatal.
Meningitis. An infection and inflammation of the membranes (meninges) and fluid (cerebrospinal fluid) surrounding your brain and spinal cord, meningitis can be life-threatening. As a complication of histoplasmosis, meningitis occurs primarily in people with compromised immune systems, although it occasionally develops in otherwise healthy people.

Preparing for your appointment
By Mayo Clinic staff
You're likely to start by first seeing your family doctor or a general practitioner. However, you may then be referred to a doctor who specializes in infectious diseases. Depending on your symptoms and the severity of your infection, you may also see other doctors, such as a lung specialist (pulmonologist) or a heart specialist (cardiologist).
Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
Write down key personal information, including any possible exposure to areas with numerous birds or bats.
Make a list of all medications, vitamins and supplements that you're taking.
Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For histoplasmosis, some basic questions to ask your doctor include:
What's the most likely cause of my symptoms?
How could I have gotten this infection?
What kinds of tests do I need? Do these tests require any special preparation?
Will this infection get better on its own or do I need treatment?
What treatments are available, and which do you recommend?
What types of side effects can I expect from treatment?
Are there any alternatives to the primary approach that you're suggesting?
I have other health conditions. How can I best manage them together?
Is there a generic alternative to the medicine you're prescribing me?
Can I get infected again?
Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend visiting?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
When did you first begin experiencing symptoms?
Have your symptoms been continuous or occasional?
How severe are your symptoms?
Do you work outdoors?
Have you spent an extended time in areas with large populations of birds?
Have you spent any time in caves? Or other areas where bats might congregate?

Tests and diagnosis
By Mayo Clinic staff
Histoplasmosis can cause a variety of signs and symptoms, many of which resemble those of other illnesses. For that reason, it can be particularly challenging to diagnose. Complicating the matter further is the large number of tests available for detecting the presence of the fungus — each of which has some limitations. These tests include:
Fungal culture. This is considered the gold standard for confirming a diagnosis of histoplasmosis. During the test, a small amount of blood, mucus or tissue from your lymph nodes, lungs or bone marrow is placed on a medium that enhances the growth of fungus and is then checked for the presence of H. capsulatum. The drawback is the time it takes for the fungus to grow — up to four weeks. For that reason, it's not a good choice in cases of disseminated disease where delayed treatment may prove fatal.
Fungal stain. In this test, a tissue sample, which may be taken from mucus, bone marrow, your lungs or a skin sore, is stained with dye and examined under a microscope. The accuracy of the test depends on the type of sample obtained and the skill and experience of the examiner. Other organisms can resemble H. capsulatum under the microscope, so confirmation with another test is desirable if an organism resembling H. capsulatum is identified.
Urine and blood tests. Antigens and antibodies can be found in your urine and blood. It's a quick and fairly accurate way of detecting disseminated histoplasmosis as well as chronic or mild cases of the disease. But false-negative results are a problem, especially in people who have compromised immune systems or are infected with other types of fungi. The test can also be positive in people who live in areas where histoplasmosis is common and have had past exposure to H. capsulatum, even though their current symptoms may be due to something else.
Depending on your signs and symptoms and the severity of your illness, your doctor may recommend other tests, such as:
Chest X-ray. Although not normally used to definitively diagnose histoplasmosis, an ordinary chest X-ray can show inflammation and damage in your lungs.

[posey]

Computerized tomography (CT). This X-ray technique produces more-detailed images than do standard X-rays. CT can be especially helpful for detecting complications from histoplasmosis.
Bronchoscopy. Your doctor may use this test to help establish a diagnosis of histoplasmosis if the disease hasn't already been confirmed by a fungal culture, stain or blood test. During the procedure, your doctor examines your windpipe (trachea) and the air passages leading to your lungs using a thin, lighted tube (endoscope). A small sample of tissue (biopsy) can be taken through the endoscope.

Treatments and drugs
By Mayo Clinic staff
Treatment usually isn't necessary if you have a mild case of acute histoplasmosis. But if your symptoms are severe or you have the chronic or disseminated forms of the disease, you'll likely need treatment with one or more antifungal medications — most often amphotericin B (Fungizone IV) and itraconazole (Sporanox). The specific drug and the length of treatment depend on the type and severity of your illness as well as on your overall health.
In general, one of several formulations of amphotericin B is the initial treatment of choice for people with disseminated histoplasmosis or severe disease. But because these drugs can be toxic to the kidneys and must be administered intravenously, doctors usually switch to itraconazole within a few days to a few weeks, depending on how your condition improves. Corticosteroids are also sometimes given initially if you have severe respiratory disease and difficulty maintaining oxygen levels in your bloodstream.
Itraconazole alone may be effective in mild cases of disseminated histoplasmosis as well as in chronic pulmonary disease. Although itraconazole doesn't work as quickly as amphotericin B, it has fewer side effects and can be taken in pill form. While using this medication, you may experience headache, dizziness, nausea, vomiting or diarrhea, but these symptoms often go away over time. If you have a history of liver or kidney problems, or another lung disease, you'll need to be monitored closely during treatment.
If you're not a candidate for itraconazole or can't tolerate the medication, your doctor may prescribe fluconazole (Diflucan), another antifungal drug. Fluconazole isn't as effective as itraconazole, however, and you're more likely to experience a relapse with this medication.

Prevention
By Mayo Clinic staff
It's difficult to prevent exposure to the fungus that causes histoplasmosis, especially in areas where the disease is widespread. Even so, these steps can help reduce the risk of infection:
Spray contaminated soil. Before you work in or dig soil that's likely to harbor H. capsulatum, spray it thoroughly with water. This can help prevent spores from being released into the air. Spraying chicken coops and barns before cleaning them also can reduce your risk.
Use an effective face mask. One of the best ways to protect yourself from soil-borne organisms if you must work in contaminated areas or in caves known to harbor bats is to wear personal protective equipment. The National Institute for Occupational Safety and Health (NIOSH) recommends wearing a well-fitting part 84 particulate respirator certified by NIOSH.
If your immune system is compromised, avoid renovation projects that might expose you to contaminated soil. Likewise, cave exploring and raising birds, such as pigeons or chickens, aren't advised.

References
Histoplasmosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. Histoplasmosis: Fungi: Merck Manual Professional. Accessed Oct. 13, 2009.
Hage CA, et al. Histoplasmosis. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. AccessMedicine | Etiology. Accessed Oct. 28, 2009.
Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Arlington, Va. Infectious Diseases Society of America. Clinical Infectious Diseases. 2007; 45:807.
Wheat LJ, et al. Diagnosis and management of pulmonary histoplasmosis. UpToDate Inc.. Accessed Oct. 14, 2009.
Histoplasmosis: Protecting workers at risk. Centers for Disease Control and Prevention. http://www.cdc.gov/niosh/docs/2005-1...s/2005-109.pdf. Accessed Oct. 28, 2009.
Kaufman CA. Histoplasmosis. Clinics in Chest Medicine. 2009;30:217.
Wheat LJ, et al. Pathogenesis and clinical features of pulmonary histoplasmosis. UpToDate Inc.. Accessed Oct. 14, 2009.
Steckelberg JM (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 3, 2009.

Histoplasmosis: Symptoms - MayoClinic.com

[posey]

By Mayo Clinic staff
Pericarditis is a swelling and irritation of the pericardium, the thin sac-like membrane that surrounds your heart. Pericarditis often causes chest pain and sometimes other symptoms. Pericarditis is usually sudden and short-lived (acute).
When symptoms develop more gradually or persist, the pericarditis is considered chronic. The sharp chest pain associated with pericarditis occurs when the inflamed or irritated two layers of the pericardium rub against each other.
Mild cases may improve on their own. Treatment for more-severe cases may include medications and, rarely, surgery. Early diagnosis and treatment may help to reduce the risk of long-term complications.

Symptoms
By Mayo Clinic staff
Acute pericarditis usually lasts less than a few weeks. Chronic pericarditis usually lasts six months or longer.
If you have acute pericarditis, the most common symptom is sharp, stabbing chest pain behind the breastbone or in the left side of your chest. However, some people with acute pericarditis describe their chest pain as dull, achy or pressure-like instead, and of varying intensity.
The pain of acute pericarditis may travel into your left shoulder and neck. It often intensifies when you lie down or inhale deeply. Coughing, taking a deep breath or swallowing food also may make the pain worse. Sitting up and leaning forward can often ease the pain. At times, it may be difficult to distinguish pericardial pain from the pain that occurs with a heart attack.
Chronic pericarditis is usually associated with chronic inflammation and may result in fluid around the heart (pericardial effusion). The most common symptom of chronic pericarditis is chest pain.
Depending on the type, signs and symptoms of pericarditis may include some or all of the following:
Sharp, piercing chest pain over the center or left side of your chest
Shortness of breath when reclining
Low-grade fever
An overall sense of weakness, fatigue or feeling sick
Dry cough
Abdominal or leg swelling
When to see a doctor
Seek immediate medical care if you develop new symptoms of chest pain.
Many of the symptoms of pericarditis are similar to those of other heart and lung conditions. The sooner you are evaluated, the sooner you can receive proper diagnosis and treatment. For example, although the cause of acute chest pain may be pericarditis, the original cause could be a heart attack or a blood clot of the lungs (pulmonary embolus).

Causes
By Mayo Clinic staff
Under normal circumstances, the two-layered pericardial sac that surrounds your heart contains a small amount of lubricating fluid. In pericarditis, the sac becomes inflamed and the resulting friction from the inflamed sac leads to chest pain.
In some cases the amount of fluid contained in the pericardial sac may increase, causing a pericardial effusion.
The cause of pericarditis is often hard to determine. In most cases doctors are either unable to determine a cause (idiopathic) or suspect a viral infection.
Pericarditis can also develop shortly after a major heart attack, due to the irritation of the underlying damaged heart muscle. In addition, a delayed form of pericarditis may occur weeks after a heart attack or heart surgery because of antibody formation. This delayed pericarditis is known as Dressler's syndrome. Many experts believe Dressler's syndrome is due to an autoimmune response, a mistaken inflammatory response by the body to its own tissues — in this case, the heart and pericardium.
Other causes of pericarditis include:
Systemic inflammatory disorders. These may include lupus and rheumatoid arthritis.
Trauma. Injury to your heart or chest may occur as a result of a motor vehicle or other accident.
Other health disorders. These may include kidney failure, AIDS, tuberculosis and cancer.
Certain medications. Some medications can cause pericarditis, although this is unusual.

Complications
By Mayo Clinic staff
Complications may include:
Constrictive pericarditis. Some people with pericarditis, particularly those with long-term inflammation and chronic recurrences, can develop permanent thickening, scarring and contraction of the pericardium. In these people, the pericardium loses much of its elasticity and resembles a rigid case that's tight around the heart, which keeps the heart from working properly. This condition is called constrictive pericarditis and often leads to severe swelling of the legs and abdomen, as well as shortness of breath.
Cardiac tamponade. When too much fluid collects in the pericardium, a dangerous condition called cardiac tamponade can develop. Excess fluid puts pressure on the heart and doesn't allow it to fill properly. That means less blood leaves the heart, which causes a dramatic drop in blood pressure. If left untreated, cardiac tamponade can be fatal.
Early diagnosis and treatment of pericarditis usually reduces the risk of the long-term complications.

[posey]

Preparing for your appointment
By Mayo Clinic staff
You're likely to start by first seeing your family doctor or an emergency room physician. In some cases when you call to set up an appointment, you may be referred to a doctor who specializes in the diagnosis and treatment of heart conditions (cardiologist).
Here's some information to help you prepare for your appointment.
What you can do
Write down any symptoms you're experiencing and for how long. Also note if you've had similar symptoms that have come and gone in the past.
Make a list of your key medical information, including other recent health problems you've had and the names of any prescription and over-the-counter medications you're taking.
Find a family member or friend who can come with you to the appointment, if possible. Someone who accompanies you can help remember what the doctor says.
Write down the questions you want to be sure to ask your doctor.
For pericarditis, some basic questions to ask your doctor include:
What is likely causing my symptoms?
Are there any other possible causes for these symptoms?
What kinds of tests do I need? Will I need to be hospitalized for testing?
What treatment approach do you recommend?
How soon after I begin treatment can I expect improvement in my symptoms?
What are the possible side effects of the treatments you're prescribing?
If the first treatment isn't effective, what will we try next?
What is the risk of these symptoms recurring?
Am I at risk of long-term complications from this condition?
How often will I need follow-up appointments for this condition?
Do I need to follow any restrictions?
Are there any special guidelines for managing this condition along with my other health conditions?
Should I see a specialist?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:
What are your symptoms?
In what part of your chest is your pain located?
Did your symptoms come on gradually or suddenly? When?
Have you had similar symptoms in the past?
Are you having any difficulty breathing?
How does sitting up and leaning forward affect your pain?
How does lying down affect your pain?
Does anything else make your pain better or worse?
Have you recently had a cold or the flu?
Have you recently had a fever?
Have you recently lost weight without trying?
Have you been diagnosed with any other medical conditions?
Do any of your first-degree relatives — parents, siblings or children — have a history of heart disease?
Do you or did you smoke? How much?

Tests and diagnosis
By Mayo Clinic staff
Your doctor likely will start by taking your medical history and asking questions about your chest pain and other symptoms. As part of your initial evaluation, your doctor will also perform a physical exam and check your heart sounds.
While listening to your heart, your doctor will place a stethoscope on your chest to check for the sounds characteristic of pericarditis, which are made when the pericardial layers rub against each other. This characteristic noise is called a pericardial rub.
Your doctor may have you undergo tests that can help determine whether you've had a heart attack, whether fluid has collected in the pericardial sac, or whether there are signs of inflammation. Your doctor may use blood tests to determine if a bacterial or other type of infection is present. You may also undergo one or more of the following diagnostic procedures:
Electrocardiogram (ECG). In this test, patches with wires (electrodes) are attached to your skin to measure the electrical impulses given off by your heart. Impulses are recorded as waves displayed on a monitor or printed on paper. Certain ECG results may indicate pericarditis, while others could indicate a heart attack.
Chest X-ray. With an X-ray of your chest, your doctor can study the size and shape of your heart. Images of your heart may show an enlarged heart if excess fluid has accumulated in the pericardium.
Echocardiogram. This test uses high-frequency sound waves to create an image of your heart and its structures, including fluid accumulation in the pericardium. Your doctor can view and analyze this image on a monitor.
Computerized tomography (CT). This X-ray technique can produce more-detailed images of your heart and the pericardium than can conventional X-ray studies. CT scanning may be done to exclude other causes of acute chest pain, such as a blood clot in a lung artery (pulmonary embolus) or a tear in your aorta (aortic dissection). CT scanning can also be used to look for thickening of the pericardium that might indicate constrictive pericarditis.
Magnetic resonance imaging (MRI). This technique uses a magnetic field and radio waves to create cross-sectional images of your heart that can reveal thickening or other changes in the pericardium.