Pericardium is another name for pericardium, which is the membrane surrounding the heart. If the pericardium becomes inflamed, we call it pericarditis. There are several conditions that can cause pericarditis and sometimes the condition is the result of a tumor of the lungs or esophagus. However, in most cases the cause is unknown. What symptoms can you expect with pericarditis, how is the diagnosis made and what are the options to treat the inflammation? What is chronic constrictive pericarditis?
- The pericardium or pericardium
- Inflammation of the pericardium or pericarditis
- Causes of pericarditis
- Symptoms of pericarditis
- Chronic constrictive pericarditis
- Complications of pericarditis
- Diagnosis of pericarditis
- Treatment of pericarditis
- Pericarditis prognosis
The pericardium or pericardium
The pericardium or pericardium is a membrane composed of two layers. It envelops the heart. The inner layer is attached to the heart. There is some liquid in between, so the layers slide smoothly over each other. This allows the heart to contract without being hindered.
Inflammation of the pericardium or pericarditis
With inflammation of the pericardium, the membrane is inflamed, usually caused by an infection. The inflammation is usually acute and the symptoms are often confused with those of a myocardial infarction. The inflammation usually disappears after a week.
Causes of pericarditis
- In young people, a viral infection is often the cause.
- Pericarditis can also be a complication after bacterial pneumonia.
- After a heart attack, the pericardium can become inflamed if the muscle near the surface of the heart is affected.
- There are countries where tuberculosis is an important cause of an inflamed pericardium.
- The pericardium can also become inflamed if a cancerous tumor spreads to the heart from another part of the body.
- Autoimmune diseases can sometimes lead to pericarditis, for example: systemic lupus erythematosus, rheumatoid arthritis, etc.
Symptoms of pericarditis
With acute pericarditis, the symptoms develop within a few hours and can last about a week. It may involve pain in the center of the chest and that pain becomes more intense when someone breathes deeply, coughs, or moves. The pain decreases when you bend forward. Furthermore, a painful feeling in the neck and shoulders, an increased body temperature and a fast heart rate.
Chronic constrictive pericarditis
In chronic constrictive pericarditis, but also if there is a lot of fluid in the pericardium, the heart may have difficulty pumping blood through the body. Due to this poor blood circulation, other complaints can develop over the course of a few months, such as swelling of the ankles, swelling of the lower body, shortness of breath. The heartbeat may also become irregular.
Complications of pericarditis
Very occasionally the inflammation does not go away. The pericardium becomes damaged, thickens and causes compression of the heart. The heart can no longer pump properly. It is called constrictive pericarditis, a chronic condition that is serious. In both variants of pericarditis, fluid can get between the layers of the pericardium, which leads to reduced pumping and can cause chronic heart failure. In chronic heart failure, fluid accumulates in tissues and in the lungs.
Diagnosis of pericarditis
An X-ray of the chest can be made, an electrocardiography (ECG) and an echocardiogram can also be done. This last examination can be used to see what the heart looks like internally. The thickness of the pericardium can be measured and it can be checked whether there is fluid around the heart. Blood tests can determine whether it is an infection or an autoimmune disease.
Treatment of pericarditis
Pericarditis requires admission to hospital . The pain and inflammation must be addressed, this can be done by using anti-inflammatories. If there is a bacterial infection, antibiotics will be prescribed. If an autoimmune disease is the cause, corticosteroids will be given and, in the case of tuberculosis, medication that can curb this disease. In the case of pericardial fluid, the fluid can be aspirated; if it reappears, a piece of the pericardium can be removed. The moisture will then drain automatically. If someone suffers from chronic constrictive pericarditis, most of the pericardium can be removed through surgery. The heart will then be able to pump properly again.
Someone who suffers from pericarditis caused by a virus will usually recover within a week. What must be taken into account is that approximately ten percent will develop pericarditis again within a few weeks. In an autoimmune disease, the inflammation can also return. Surgery for chronic constrictive pericarditis is not always successful.
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