Why Do Patients Develop Pericarditis Again

• What Is
  • Pericarditis definition and facts
  • What is pericarditis?
• Symptoms
  • What are the symptoms of pericarditis?
• Causes
  • What causes pericarditis?
• Diagnosis
  • How is pericarditis diagnosed?
• Treatments
  • What is the treatment for pericarditis?
• Complications
  • What are the complications of pericarditis?
• Center
  • Pericarditis Center
• Comments
  • Patient Comments: Pericarditis - Describe Your Experience
  • Patient Comments: Pericarditis - Symptoms and Signs
  • Patient Comments: Pericarditis - Treatment
  • Patient Comments: Pericarditis - Causes
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Pericarditis definition and facts

Picture show of the heart in the pericardial sac

• Pericarditis is an inflammation of the lining surrounding the eye (the pericardial sac).
• Pericardial effusion is a collection of fluid in the pericardial sac. This fluid may be produced past inflammation.
• The cause of pericarditis in near individuals is unknown but is likely due to viral infection. Pericarditis may be an associated complication of many diseases or may exist due to trauma.
• The diagnosis of pericarditis is made past history and physical examination. Testing usually includes an electrocardiogram (EKG, ECG), chest X-ray, and echocardiogram, or ultrasound of the middle. The inflammation of pericarditis is usually treated with anti-inflammatory medications (such every bit ibuprofen). It is important to care for the underlying affliction or illness if one is present.
• Pericardial tamponade occurs when enough fluid accumulates in the sac to compromise the heart'southward ability to adequately pump claret.
• Tamponade is a medical emergency and is treated by pericardiocentesis, inserting a needle into the pericardial sac to remove the fluid.

What is pericarditis?

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The middle muscle has a tight roofing that surrounds information technology, a lining sac called the pericardium (peri=around+cardium=heart). This sac actually has ii layers. The visceral pericardium is only one cell layer thick and fits tightly onto the heart musculus. The parietal pericardium is much tougher and thicker and has fibers that tether the heart to the rib muzzle and diaphragm. At that place is a potential space between the layers, significant that in normal situations, information technology has a minimal corporeality of fluid. Notwithstanding, should inflammation occur, information technology can fill up with fluid. Inflammation of the lining of the heart is called pericarditis (itis=inflammation).

Pericarditis Definition

Possible causes

Pericarditis is inflammation of the lining around the heart (the pericardium) that causes chest pain and accumulation of fluid around the middle (pericardial effusion). There are many causes of pericarditis, including:

• Infections
• Injury
• Radiation treatment
• Chronic diseases

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What are the symptoms of pericarditis?

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Chest pain is the most mutual symptom of pericarditis.

• Classically, the pain begins in the heart of the breast and radiates to the neck or upper dorsum.
• The pain is sharp and stabbing, but may also be felt as a dull anguish or called-for pain.
• The intensity may be balmy or very astringent and information technology can come on gradually or suddenly.
• The pain makes it hurt to take a breath.
• Almost individuals feel worse when lying flat.

Other symptoms may include fevers and chills, sweats, shortness of jiff, and difficulty swallowing.

When pericarditis is due to infection, the symptoms tend to arise rapidly. Inflammation due to chronic diseases is more than gradual in onset.

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How is pericarditis diagnosed?

History and physical examination

The diagnosis of pericarditis begins with the health care professional person taking a history virtually the hurting and its character. The health care professional will perform a physical test and ask the patient near associated symptoms. Past medical history is important, since pericarditis can be a complication of a chronic affliction or a side issue of medication.

The near common physical finding that helps confirm the diagnosis of pericarditis is a pericardial friction rub. Inflammation prevents the ii layers of pericardium from easily sliding against each other with each heartbeat. The inflammation causes a friction dissonance that can be heard with a stethoscope when listening to the heart. It is better heard when the patient leans frontward, which causes the heart to shift to the front end of the breast. The rub may non always be nowadays and may come and go from 60 minutes to hour.

Diagnostic testing

The electrocardiogram (EKG or ECG) shows electrical activity of the heart. In pericarditis, in that location are authentication changes that are seen and can help make the diagnosis. While an abnormal EKG is helpful in making the diagnosis, in the early stages of inflammation, the EKG may exist normal. In nigh cases of simple pericarditis, a breast Ten-ray is usually normal. Even so, if fluid accumulates in the pericardial sac, the center can appear larger on the X-ray.

A sound wave test of the eye (an echocardiogram or ultrasound of the heart) is very helpful in detecting and quantifying the fluid in pericarditis. The purpose of the exam is to detect an accumulation of fluid in the pericardial sac, called an effusion. Although in many mild cases of astute pericarditis, at that place is no pericardial fluid seen with echocardiography. A variety of claret tests may be ordered depending upon the clinical situation.

Pericardiocentesis (delight run into below), a process using a needle, is used to draw fluid out of the pericardial sac. It may be done to detect bacterial infection. This procedure can also be used to treat dangerous, astringent pericarditis called pericardial tamponade.

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What is the handling for pericarditis?

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Near often, pericarditis is caused by a viral infection and the handling is aimed at decreasing inflammation and controlling pain. Nonsteroidal anti-inflammatory drugs or NSAIDs (ibuprofen [Motrin and others], naproxen [Aleve, Naprosyn, and others]) are commonly used. A short course of narcotic pain medication may be helpful. For other causes of pericarditis, treatment of the underlying cause of pericarditis is essential.

Pericardiocentesis, a procedure where a thin needle is inserted through the chest wall into the pericardial sac, may be considered if a large effusion is present that affects heart office (see cardiac tamponade beneath).

Pericardotomy (cutting a hole in the pericardial sac) or pericardectomy (removing the sac completely) may be needed for recurrent pericarditis that causes scarring inside the pericardial sac and prevents the heart from beating properly.

What are the complications of pericarditis?

Cardiac tamponade

If enough fluid accumulates in the pericardial sac, it can affect heart function and subtract blood force per unit area. The fluid can accumulate gradually over time or can gather chop-chop, depending on the crusade. The increased corporeality of fluid tin cause a rise in pressure within the pericardial sac. This causes two potential problems:

• The ventricles or lower chambers of the heart responsible for pumping blood to the body have difficulty filling with blood because the fluid in the sac prevents them from filling with blood. That means there is less blood to send to the body with each heartbeat.
• The increased force per unit area within the pericardium may subtract the amount of blood that can return to the middle. The less blood that returns means in that location is less to pump out with the next heartbeat.

If a affliction causes the pericardial effusion to increase in size slowly, symptoms may come on gradually and the heart can adapt. The symptoms may be nonspecific but can include shortness of breath and difficulty with practise or doing daily activities. But if the fluid accumulates quickly, like haemorrhage because of trauma, small amounts of fluid tin cause pregnant issues.

Cardiac tamponade is a medical emergency and the patient may be in stupor with depression blood pressure level, difficulty breathing, and congestive centre failure. The classic findings of cardiac tamponade are:

• low blood force per unit area;
• distended veins in the neck (jugular vein bulging); and
• deadened heart tones using a stethoscope.

Testing requires emergent EKG, portable chest X-ray, and echocardiogram. Some hospitals are not staffed 24 hours a 24-hour interval past a cardiologist or with an echocardiogram and the diagnosis is often made clinically.

Cardiac tamponade is a true medical emergency that requires pericardiocentesis, a procedure where a long needle is inserted through the breast wall into the pericardial sac and the fluid is removed. This relieves the pressure within the sac and temporarily resolves the acute emergency. A plastic tube or catheter may be left in the chest until the underlying illness that caused the tamponade is treated and stabilized.

Constrictive pericarditis

Recurrent inflammation of the pericardial sac can lead to scarring of the infinite between the two layers of the pericardial sac. The scarring constricts the movement of the center during each heartbeat and can prevent the middle from expanding to take blood returning from the body after each heartbeat. This affects centre function and cardiac output because with less claret returning with each beat out, in that location is less that can exist pumped out with the next heartbeat.

Bleeding into the pericardium from trauma or from a centre performance is the most common cause of constrictive pericarditis, but tumors, or infections like tuberculosis or fungus, tin can also be the cause.

The constriction occurs slowly over time and will cause shortness of breath on exertion and decreased ability to exercise. Swelling in the legs and the belly may be because it is difficult for blood to return to the heart, and the back pressure in the veins causes fluid to leak out into the tissues.

Diagnosis is made once more by history, physical examination, EKG, echocardiography, and sometimes computerized tomography (CT) of the chest.

If there is meaning scarring of the pericardial sac, pericardotomy -- an operation to dissever open the pericardium to gratis up the constriction -- may be required to improve function. If the whole pericardium must be stripped away from the heart muscle, the procedure is chosen a pericardectomy.

IMAGES

Pericarditis (Symptoms, ECG, Types, Causes, Treatment) Come across a detailed medical illustration of the heart plus our unabridged medical gallery of human anatomy and physiology See Images

References

Kasper, D.L., et al., eds. Harrison'southward Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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