Pericarditis is a heart disorder in which the lining of the heart (called the pericardium) becomes inflamed. The pericardium is the double membrane sac that surrounds the heart and holds it in position within the chest. It also protects the heart from infections arising in other organs. This layer is flexible and makes sure the heart does not increase in size too quickly when pumping blood. There is a fluid in this sac called the pericardial fluid that lubricates the internal tissues and reduces the friction produced by heart activity.
What are the Main Types Of Pericarditis?
Pericarditis can be either acute or chronic in nature. Acute pericarditis develops suddenly and is typically resolved within three weeks with rest and therapy. In Chronic pericarditis, the symptoms develop gradually over a period of many months. It also takes longer to treat the condition and more often than not, the patient develops further complications.
What are the Most Common Symptoms of Pericarditis?
The patients typically complain of a sharp pain the chest that resembles the pain experienced during a heart attack. This pain worsens on inhaling and improves when the patient leans forward while sitting up. The patients also experience low blood pressure, a high temperature (fever) and heart palpitations.
How Serious is Pericarditis?
If left untreated, pericarditis may lead to other serious heart disorders such as chronic constrictive pericarditis and cardiac tamponade.
Chronic Constrictive Pericarditis: Chronic constrictive pericarditis is another condition that may develop if pericarditis is untreated over a prolonged period. When the pericardium continues to experience inflammation over a long period, it gradually starts developing scar tissue. This makes it lose its flexibility and becomes more rigid. Thus, now the heart is not able to fill at the earlier capacity and this keeps worsening over time. This results in a development of a chronic constrictive pressure on the heart muscles and this condition is termed chronic constrictive pericarditis.
The patients generally experience severe swelling in the regions of their arms and legs along with shortness of breath, fatigue and some degree of chest pain.
The goal of the treatment is to reduce the pressure on the heart by either removing the excess fluid using diuretics, reducing the inflammation of the pericardium by using non-steroidal anti-inflammatory drugs, corticosteroids or colchicine and taking pain killers to combat the chest pain. It is also advisable to decrease the physical activity level to give the heart time to recover.
Cardiac Tamponade: Cardiac tamponade is a condition that may develop if there is excessive fluid accumulated in the pericardium. This fluid creates a lot of pressure on the heart and so does not allow the heart to fill properly with blood. This means the heart is now pumping out less quantity of blood and this causes the blood pressure to decrease. Excessive low blood pressure over a prolonged period could be life threatening.
Cardiac tamponade is most commonly seen in patients who develop pericarditis due to cancer or tuberculosis. The patients typically exhibit clinical symptoms of persistent low blood pressure, chest pain that spreads to the neck, shoulder or back and discomfort that is lessened when the patient leans forward.
Cardiac tamponade is generally treated with pericardiocentesis, an invasive surgical procedure carried out under local anesthesia. During this procedure, the doctor will a catheter (thin plastic tube) through the chest and into the pericardium. This catheter is used to remove the excess fluid built up in the pericardial cavity. The patients are also given fluids and medications to increase their blood pressure.
What is the Prognosis of the Serious Complications of Pericarditis?
Serious complications of pericarditis need immediate medical attention and prompt treatment. If these not diagnosed and treated at the right stage, it can be life threatening as the probability of developing heart failure significantly increases. Early diagnosis and treatment reduces the risk of developing long-term complications and increases the likelihood that the patients will go on to lead healthy lives.
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