Pericarditis

The heart is surrounded by a double-layered membrane that is shaped like a sac and is called the pericardium. The pericarditis is inflammation or irritation of the pericardium, a condition characterized by pain cause acute chest when the membrane layers rub against each other. It occurs mostly suddenly, is not considered a high-risk condition, and usually progresses without the need for treatment.

When pericarditis manifests gradually and symptoms persist over time, it is considered to be chronic. If the condition worsens, medication may be necessary. Diagnosing this heart condition early is vital to prevent complications in the future and prevent the person from having to undergo surgery. In this eHealth article we explain in detail what this disease consists of.

Types of pericarditis

Depending on its symptoms and duration, pericarditis can be:

Sharp

It occurs suddenly and can cause inflammation of the pericardial cavity or pericardial effusion. Also, the swelling may extend to the epicardial myocardium.

Chronicle

It is an inflammation of the pericardium that has lasted for more than 6 months.  

Subacute

It is the one that appears time after a triggering factor. Usually this condition is a consequence of acute pericarditis.

Symptoms of pericarditis

Acute pericarditis can last less than three weeks, subacute no more than three months, and chronic more than six months. In the case of acute, chest pain is considered the most characteristic symptom. This discomfort can be located on the left side of the body or behind the breastbone and is often described as pressure that varies in intensity.

Chest pain can also radiate to the left arm and neck. This symptom is worse when the person is lying down, coughing, or breathing deeply and usually improves when sitting or leaning forward. Many people often confuse the pain of pericarditis with that of a heart attack.

Chronic pericarditis manifests itself through prolonged inflammation that can lead to the appearance of fluid in the heart, a condition known as pericardial effusion. People who have this type of pericarditis also experience the chest pain of acute pericarditis. Also, this condition can cause other symptoms, such as:

• Difficulty breathing when leaning forward.
• Fast heartbeat
• Weakness, fatigue, and nausea.
• Swelling of the abdomen and extremities.
• Cough.

Causes of pericarditis

The pericardium normally contains a small amount of lubricant between its two layers. When pericarditis occurs, the inflammation of the membranes and the friction of the same cause the characteristic pain in the chest. Why does this happen? At present, the specific cause of this disease is still unknown and in the absence of an idiopathic cause, there are those who suspect that it is a viral infection.  

There are also cases in which pericarditis appears shortly after a heart attack due to damage to the heart during the heart attack. This condition is called Dressler Syndrome, Postmyocardial Infarction Syndrome or Postcardiac Injury Syndrome. Other situations associated as causes are:

• Inflammatory disorders that take place in the body due to diseases such as lupus and arthritis .
• Any injury to the heart.
• Diseases that affect cardiovascular health such as kidney failure, AIDS , cancer, tuberculosis .
• Consumption of certain medications.

Can it get complicated?

Although it is usually rare, people with recurrent pericarditis may have the following complications:

Constrictive pericarditis

When pericarditis is chronic, it can be complicated by contraction, thickening or scarring of the pericardium, turning the membrane into a kind of rigid covering that covers the heart and preventing the muscle from working normally. and abdomen and shortness of breath.   

Cardiac tamponade

It occurs when too much lubricating fluid builds up in the pericardium that puts pressure on the heart and prevents the muscle from working properly. This condition prevents blood from flowing properly from the heart and causes low blood pressure. Treating this condition early is vital to prevent death.

Diagnosis of pericarditis

The first thing that the person should do in the presence of symptoms of pericarditis is to go immediately to the doctor, remember that the discomfort of this condition is similar to that of a heart attack. Once at the medical care center, the specialist will listen to the heart and, if it is pericarditis, they will hear an abnormal noise known as pericardial rubbing. When the disorder is considered to be serious, the doctor will also find decreased breath sounds, fluid in the lungs, and lung crepitus.

Among the tests performed to examine the pericardium are:

• Chest MRI.
• Chest X-ray.
• Echocardiography
• Electrocardiogram.
• CT of the heart.
• Scintigraphy

It will also be necessary to rule out any year in the myocardium by performing blood tests such as antinuclear antibody, HIV, blood culture, total blood count, C-reactive protein , rheumatoid factor, tuberculin skin test and erythrocyte sedimentation.  

Treatment and prognosis of pericarditis

Before prescribing any treatment, the doctor must rule out that it is a consequence of another condition, in this case, the treatment will consist of first attacking the cause of the pericardial inflammation.

When pericarditis is caused by an infection, the person should take antibiotic or antifungal medications, depending on the pathogen that caused the condition.

Diuretics to help drain excess fluid, anti-inflammatories such as ibuprofen , corticosteroids, and pain relievers to relieve chest pain may also be prescribed .

When pericarditis has compromised the proper function of the heart, treatment may include:

• Hole in the heart for fluid from the pericardium to flow into the abdominal cavity
• A pericardiocentesis to drain fluid into the sac. The doctor performs this treatment using a needle and guided through an echocardiogram.

Pericarditis can be a mild and temporary condition, but it can also be chronic and cause damage to the heart due to the accumulation of fluid that it can generate. However, when this disease is treated in time, the prognosis for successful cure is quite high, in fact, most people recover within 3 months.

The inflammation can reoccur and when this happens the person is considered to have recurrent or chronic pericarditis. People with this type of condition are at higher risk for complications resulting from heart failure. In conclusion, in the event of any symptoms of pericarditis, it is best to go immediately to the doctor and comply with the prescribed treatment to the letter.