What is Pericarditis?
Pericarditis is a heart disorder in which the lining of the heart becomes inflamed. This lining is called the pericardium.
What is the Role of the Pericardium?
The pericardium consists of two main layers: the outer tough layer called the fibrous pericardium and the internal thin layer called the serous pericardium. The fibrous pericardium holds the heart in place and separates it from the adjacent internal organs. This layer is less flexible and does not stretch much, so it is helpful to prevent overfilling of the heart with blood. The serous pericardium further consists of two layers between which are the pericardial cavity that contains a small quantity of fluid called the pericardial fluid. This helps to lubricate the heart and prevents the friction caused by heart movement within the thoracic cavity.
What are the Clinical Symptoms Of Pericarditis?
As described above, the pericardium has many important physiological functions that aid in the smooth running of the heart. Pericarditis leads to malfunction in performing these functions. The swelling of the pericardium causes the tissues in the heart to rub against each other and increases the internal friction. This affects the speed with which the heart contracts and relaxes. Prolonged irritation to the tissues causes excess fluid to collect in the pericardial cavity. This increases the pressure on the heart walls and in turn affects the capacity of the blood the human heart can pump.
The most common clinical symptom experienced by patients is sudden chest pain that resembles a heart attack. The patients also experience low blood pressure, a high temperature (fever) and heart palpitations.
Can You Cure Pericarditis?
Most mild cases of pericarditis resolve on its own or through medication with adequate rest. The patient needs to avoid all rigorous physical activity while recovering because strenuous activities can trigger back the clinical symptoms. Recovery may take from a few weeks to a few months.
Unless it is associated with complications, interventional procedures are not generally necessary. If the patient develops any complication because of pericarditis, those conditions need to be treated surgically.
The major goal of any doctor treating this condition is reducing the inflammation of the pericardium, decreasing the pain experienced by the patient, finding and curing the root cause of the disorder, and ruling out further complications. Therefore, if the pericarditis is because of a bacterial, viral or fungal infection, then the patient will be put on respective antibacterial, antiviral or antifungal therapies. If the root cause of the disorder is autoimmune, then the patient will be put on anti-inflammatory medicine. Similarly, if the cause is dialysis due to renal failure, then the doctor will need to make a change in the dialysis routine and technique.
How do we Treat the Complications of Pericarditis?
Cardiac tamponade is one condition in which there is excessive fluid collected in the pericardium. This is treated by a surgical procedure called pericardiocentesis. In this procedure, a needle/tube is inserted into the chest wall to remove excess fluid from the pericardium and thus, reduce the pressure on the heart. The patients receive local anesthesia before the procedure. The drainage continues over a period of several days while the patient is hospitalized.
Chronic constrictive pericarditis is a condition, in which the pericardium becomes very stiff because of formation of scar tissue. The only intervention to treat this condition is called pericardiectomy. In this procedure, the surgeon will remove the entire pericardium that has become stiff and is not letting the heart pump blood.
What is the Prognosis for Pericarditis?
Pericarditis usually resolves spontaneously within 3 months, though there is a possibility of recurrence intermittently for years that can be reduced by adhering to treatment plan. Complete recovery is often attainable provided the patient takes complete rest and has medical care. Pericarditis associated with a serious underlying condition like tuberculosis, bacterial infections, and cancer usually has a more guarded prognosis.