Pericarditis

Pericardium is a fluid filled two layered membrane that surrounds the outer portion of the heart. This thin layer gives protection to the heart by protecting it against infection and preventing over-expansion of the heart. If this layer of pericardium gets inflamed and develops swelling and irritation it is known as pericarditis. It can cause acute chest pain and sometimes sharp staggering pain when the layers of pericardium rub one another. Often pericarditis is short term but sometimes it can be chronic. Symptoms of sharp pain can be managed through medications and in severe cases pericarditis may need surgical process.

Types :

Pericarditis can be acute (short lived) and chronic (long term).

• Acute form of pericarditis may last only for few days or weeks. The pain may radiate from your left shoulder and passes through the neck. The pain can be mild to moderate and sometimes severe also. The symptoms of acute form resembles very much like that of a heart attack.
• Chronic form develops gradually as a process causing accumulation of fluid in the pericardial layers. The intensity of pain may range from mild to moderate and it may lasts for several weeks or months.

Symptoms :

Symptoms of pericarditis vary depending on the type and intensity of inflammation. Some of the signs of pericarditis include palpitation of the heart, sharp pain on the chest and shortness of breath. The pain would begin on the left side of your shoulder and progresses towards the chest passing through the neck. It can also cause fatigue, fever and swelling of legs. Many times, the symptoms of pericarditis are confused with lung infection or other heart diseases. You need to consult a doctor if you notice above symptoms and persistent chest pain.

Causes :

Exact cause of pericarditis is not known. It is believed to be caused due to friction arising from the rubbing of pericardial layers. Under normal condition, pericardial sac contains some fluid facilitating lubrication and movement of the heart within the limits of layer. But due to inflammation of pericardium, both the layers of pericardial sac rub over one another causing sharp pain.

If the underlying heart muscles get damaged due to heart attack, it can cause pericarditis. Some people may develop percarditis weeks after heart surgery due to the inflammation of pericardial layer. Sudden accident or trauma to the heart and systemic inflammatory disorders may lead to pericarditis.

Complications :

In rare cases, pericarditis may lead to constrictive pericardial layer causing long term inflammation and persistent problem. The thin soft layer may lose its elasticity and constrict the heart inside restricting its function. This condition can cause swelling of abdomen and legs and difficulty in breathing.

Cardiac tamponade is another complication caused by pericarditis in which excess of fluid gets filled in the layer thus disabling the heart to fill blood properly. This condition can cause sudden drop in blood pressure and can be life threatening if not treated immediately.

Who are at risk?

Anyone can develop pericarditis but it is reported to occur largely in women and people of age group 20-50.

Tests :

Your doctor can identify pericarditis by listening to your heart via a stethoscope. Expert doctor can differentiate normal heart beat rhythm and noise created by rubbing of pericardial layer. He may order for few tests like ECG, echocardiogram, chest X-ray, and computerized tomography test. Thickened pericardial layer and any abnormality in the heart can be diagnosed through CT scan.

Treatment :

The course of treatment will depend on the results of the test and severity of inflammation. Mild form of pericarditis may not require any treatment. Medications are given to reduce the swelling of pericardial layer which can control chest pain. Anti-inflammatory drugs and pain killers are effective in reducing inflammation and associated pain.

Colchicine is prescribed for managing the symptoms of acute pericarditis. But your doctor will decide whether this drug is safe for you or not. Steroids like prednisone are given for people who are not responding to other drugs. Hospitalized treatment is necessary if any complication develop due to pericarditis. In rare cases pericardiac tamponade can develop.

• Surgery :

Pericardiocentesis is done when there is excess of fluid collection in the layers of pericardium. The surgeon would insert a thin needle inside the layer to drain off the fluid from the cavity. This surgery will be performed under careful supervision of echocardiogram and ultrasound scan.

If the pericarditis is chronic and persistent affecting the normal functions of your heart, your surgeon will consider removing the pericardium. This surgery is called as pericardiectomy in which the entire pericardial sac is removed.

Images, Pics, Photos and Pictures of Pericarditis :

Outlook :

Often people with pericarditis would recover completely within few months. Only in rare cases attacks may recur frequently, needing medications and further treatment.