- Progressive increase in cardiac size on clinical examination and by
plain X-ray. Echo cardiography shows that the increase is mainly
due to fluid collection in the pericardium. It also shows the defective
cardiac filling and reduced stroke volume.
Cardiac tamponade, if not treated urgently, will be fatal. Treatment
is by pericardiocentesis.
e- Heart failure:
This is usually a left sided heart failure which is due to:
1- hypertension 2- anaemia 3- fluid overload
4- uraemic cardiomyopathy.
IV. Cutaneous manifestations:- Muddy face (sallow skin), due to retention of some toxins
(urochromogens). - Puffy face, due to salt and water retention.
- Pallor, due to anaemia.
- Dry skin with urea frost. Also the skin is fragile, thin and bruises
easily. - Pruritis results from skin dryness or from irritation of the cutaneous
sensory nerves by calcium^ deposits or by parathormone. - Purpura and skin infection.
- Nails may be white with tips discoloured brown.
V. Respiratory manifestations:
These include the following:- Kaussmaul's (acidotic or hissing) breathing
- Exertional dyspnea, paroxysmal nocturnal dyspnea with heart failure.
- Increased incidence of pulmonary infection.
- Rarely, dry uraemic pleurisy.