Pericarditis – Symptoms, Causes and Treatment

Pericardium 

It is a membrane that encloses the heart, consists of an outer fibrous layer and an inner double layer of serous membrane.

Pericardial fluid 

It is found between the two layers of tissue and keeps the layers separate, so there’s no friction between them. When fibrous and serous layers become inflamed, it induces chest pain.

Symptoms of Pericarditis

Symptoms of Pericarditis include,

• A sharp, stabbing pain within the middle or left side of the chest.
• Sitting straight / leaning forward may reduce the pain.
• Pain increases while lying down or taking a deep breath.
• Fever and cough
• Palpitations
• Difficulty breathing
• Weakness
• Pain in one or both shoulders

Chronic or Recurring Pericarditis

Chronic or recurring Pericarditis is caused by autoimmune diseases like Rheumatoid Arthritis or Scleroderma and Lupus.

With chronic cases of Pericarditis, the following conditions are observed:

• Chest pain
• Tiredness, shortness of breath and
• Cough, leg swelling (oedema) and rarely low BP.

Causes of Pericarditis

Causes of Pericarditis include,

• Heart attack or post-cardiac surgery
• Infectious diseases like Viral, Bacterial, Rheumatic fever, acute Arthritis and Uremia.
• Medical conditions like renal failure, cancer, HIV/AIDs or Tuberculosis

Pericarditis complications:

Cardiac Tamponade or Chronic Constrictive Pericarditis

Cardiac tamponade occurs when excess fluid is within the sac. This increases pressure on the heart and prevents it from filling with blood and leading to low blood pressure. If untreated, this can be fatal.

• Rare case, chronic constrictive Pericarditis could be a disease that will cause scar-like tissue within the sac that surrounds the heart; hence it becomes rigid, constrict and can prevent the heart from functioning normally.

Diagnosis and Treatment

Diagnosis can be done on Auscultation, a standard sign of Pericarditis – pericardial rub (the sound of the pericardium rubbing against the outer layer of the heart).

To grade the severity of the Pericarditis, the following tests may include blood work, echocardiogram (echo), Electrocardiogram (ECG), chest X-rays, CT scan or MRI scan.

Treatment of Pericarditis may vary based on severity.

For reducing the pain and inflammation around the heart, treating the underlying reason for Pericarditis (such as a viral infection) – Anti-inflammatory medications like prednisone are used, which alleviate the Pericarditis. And on severe conditions, a hospital stay or a surgical treatment could also be needed. Recovery can take weeks or months, reckoning on the severity of the Pericarditis.

Surgical treatment options

• Pericardiectomy, which is the removal of pericardium.
• Pericardiocentesis, an aspiration of excess pericardial fluid.

Conclusion

Pericarditis, especially acute Pericarditis, requires immediate medical attention. If left untreated, it can further worsen and lead to surgery as well as other complications. Hence detecting Pericarditis early plays an important role in reducing the severity of the disease and helps to save lives.