Can Pericarditis Lead To Congestive Heart Failure?

Can Pericarditis Lead To Congestive Heart Failure?

The question whether pericarditis leads to congestive heart failure is equivocal. ”No, pericarditis does not lead to congestive heart failure”, if it is treated on time. Pericarditis, if left untreated might lead to complications, which might further lead to congestive heart failure.

Pericarditis is the inflammation of the pericardium that is the sac-like covering of the heart and might also cause fluid buildup in the pericardial sac known as pericardial effusion. The etiology of pericarditis is mostly idiopathic, but it might also be due to virus, bacteria, trauma, certain drugs, radiation etc. It is diagnosed with the help of medical history and physical exam along with other imaging such as electrocardiogram, echocardiogram, and/or chest X-ray. The most common symptom of pericarditis is chest pain and it is mostly treated with pain medications and anti-inflammatory medications (ibuprofen), colchicines and/or steroids. If left untreated then it might lead to certain complications.

Can Pericarditis Lead To Congestive Heart Failure?

What Are The Complications Of Pericarditis?

The most common complications of untreated pericarditis are:

Cardiac Tamponade

It is the altered functioning or decreased blood pumping of the heart due to fluid accumulation in the pericardial sac. The fluid accumulates either gradually or rapidly (such as in a trauma), which depends totally on the cause. If the fluid accumulates gradually then the heart can adapt to the change and will present with symptoms such as shortness of breath and difficulty in doing daily activities leading to fatigue. However, if fluid accumulation is quick as in the case of bleeding due to trauma then even slight increase in the fluid can cause serious problems. The increased pericardial fluid can cause difficulty in ventricular blood pumping to other organs thus reducing the blood supply to other organs and also it can cause decreased return of blood from other organs to the atria, overall, leading to decreased blood in the heart with decrease in blood pressure.

Cardiac tamponade, if left untreated, may lead to shock, hypotension, difficulty breathing and even congestive heart failure. The physical exam in cardiac tamponade patient will show decreased blood pressure, muffled heart sounds on heart auscultation along with distention of neck veins. Diagnosis may also involve electrocardiogram, chest X-ray and/or echocardiogram. Cardiac tamponade demands emergency treatment needing pericardiocentesis in which a long needle is used to drain fluid out of pericardial sac. This fluid drainage relieves pressure temporarily, thus giving time to treat the underlying illness. Until then a plastic tube/catheter may be left in place for drainage of further fluid unless the patient is stabilized.

Constrictive Pericarditis

It is the scarring or thickening of the pericardium due to recurrent or chronic pericarditis. The thickening of pericardium restricts proper functioning of the heart, thus restricting proper expansion of heart causing decreased cardiac output and heart function. Constrictive pericarditis is mostly caused by bleeding in the pericardium caused by trauma or heart operation. Other causes might include infections such as tuberculosis or fungus, radiation therapy to the chest or/and tumors.

Constrictive pericarditis is a very rare condition, but it can occur in individuals who has a previous history of pericarditis and also patients dealing with autoimmune diseases (such as rheumatoid arthritis, systemic lupus, Sjogren’s syndrome) and with certain medications. Constrictive pericarditis is a slow process and the symptoms also progress slowly causing exertional shortness of breath, decreased stamina, and fatigue, swelling of extremities or abdomen, weight gain, atrial fibrillation (irregular heartbeat), chest pain and/or mild fever.

Evaluation of medical history, physical examination, electrocardiogram, echocardiogram, chest X-ray, MRI, cardiac catheterization and/or CT scan make the diagnosis of constrictive pericarditis. Since the diagnosis of constrictive pericarditis is difficult, in most cases is confused with other heart conditions, and is often misdiagnosed with cardiac tamponade or restrictive cardiomyopathy. The treatment of constrictive pericarditis includes pericardiectomy that involves removal of the thickened portion of the heart, which improves functioning of the heart.

It is better to prevent complications as far as possible by being vigilant of one’s health and taking proper measures to prevent the disease as far as possible and lead a healthy life.

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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:June 16, 2021

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