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Pericarditis – Inflammation of The Pericardium

Wednesday, July 18th 2012. | Disease, Heart Health

Pericarditis Definition

The core is enveloped by the pericardium, which is composed of two layers separated by a virtual cavity filled with liquid. The inner layer is attached to the myocardium; the outer leaflet, meanwhile, is much looser.

The pericardium has many functions: it protects the heart and supports so that vital structures of the chest (sternum, blood vessels, etc.) still retain the same position relative to the heart.

The pericardium allows expansion and contraction of the heart, eg. if efforts (heartbeat important). It also helps to adjust the amount of blood expelled from the right and left ventricles.

Inflammation of the pericardium (pericarditis) is a relatively rare heart disease, whose diagnosis has increased in recent years, however. This increase in diagnosed cases is explained partly by more accurate diagnostic techniques and better, and secondly by the increase in coronary heart disease (diseases affecting the coronary arteries).

Pericarditis can greatly hinder the cardiocirculatory function and is a medical emergency.

There are two types of pericarditis :

  • Exudative pericarditis : formation of an effusion in the pericardium.
  • Fibrous pericarditis : absence of large effusion
pericardium

Pericarditis (img : metrohealth.org)

Pericarditis Causes

Often the causes are unknown. However, pericarditis usually follows an infection or underlying disease.

Pericarditis Infectious Causes

  • Virus
  • Bacteria (tubercle bacilli, staphylococci, streptococci, pneumococci).
  • Mushrooms
  • Parasites
  • Syphilis

Diseases or conditions that can trigger pericarditis

  • Coronary heart disease
  • Myocardial infarction
  • Rheumatic fever, rheumatoid arthritis, diseases of the skeleton, connective tissue diseases.
  • Autoimmune reaction against the body’s own tissues, eg. after myocardial infarction or cardiac surgery.
  • Metabolic diseases (thyroid disease, kidney disease, diabetes, increases in blood lipids).
  • Diseases of surrounding organs (myocardial infarction or myocarditis, pneumonia, tuberculosis, disease of the esophagus).
  • Tumors, primary and secondary (metastases).
  • Thoracic lesions
  • Dental treatment (bacteria reach the pericardium through the bloodstream).
  • Radiotherapy

Pericarditis Disorders (symptoms)

Symptoms vary depending on the form of pericarditis.

Fibrous Pericarditis

Chest pain dependent respiration (increased supine and cough): pain when breathing, which cease at the end. While sitting with the torso bent forward, the symptoms are generally mitigated.

Exudative Pericarditis

In case of mild exudative pericarditis, the symptoms are moderate:

  • Weakening of the overall state
  • Increase in body temperature
  • Exhaustion General

Symptoms of increasing discomfort from Cardiac Activity :

  • Blue lips
  • Respiratory distress
  • Occlusion of large veins in the neck
  • Epigastric symptoms (enlarged liver).
  • Swelling (edema) in the arms and legs.

Symptoms of Acute Pericarditis

  •  Sudden fever and elevated in bacterial infections.
  •  Strong feeling of illness.
  • Mild to moderate fever, in case of viral infection.

Pericarditis Examinations (Diagnosis)

  • History taking into account the patient’s symptoms
  • Physical examination
  • CXR
  • Electrocardiogram (ECG)
  • Echocardiogram
  • Laboratory tests (inflammatory parameters)
  • Tuberculin skin test

Pericarditis Treatment Options

Pericarditis General Treatment

Treatment depends on the / disease (s) underlying (s). General measures to mitigate the symptoms and sequelae, such as shutdown of pericardial effusion, should be taken. In acute pericarditis, absolute rest in bed and taking antiphlogistic have a beneficial effect generally fast.

Pericarditis Medical drugs Treatment

Depending on the cause of the disease, treatment is based on antibioques in combination with cortisone. Treatment of underlying diseases: immunosuppressive drugs in cases of autoimmune disease, treating a disorder of renal function, hypothyroidism, or cancer treatment. Analgesics can be used to fight against the chest pain.

To prevent the disease becomes chronic, the prescribed treatment must always be followed (duration, dosage).

Pericarditis Surgery Treatment

Puncture of the pericardium to drain the effusion. Only in extreme cases of chronic recurrent effusions, the pericardium should be a surgical fenestration, to permit flow of fluid inflammatory. In case of calcific pericarditis (scarring of the pericardium), or scars, if any, hardened and thickened pericardium should be resected surgically.

Pericarditis Possible Complications

If appropriate treatment, acute pericarditis cured in most cases. Untreated, pericarditis may impair cardiac function and cause cardiovascular collapse which may be fatal.

Pericarditis, who re-offend due to chronic diseases, can cause chronic calcific pericarditis. In case of chronic pericarditis and calcific pericarditis, myocardial lesions and / or permanent kidney damage or liver may occur.

 

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