The pericardium is the protective sac that surrounds the heart and the large vascular structures connected to it, such as the aorta and pulmonary arteries. It helps protect the heart from external attacks, such as infections or injuries, has a shock-absorbing mechanism so that they do not cause damage to the heart, and keeps it in place in the chest, limiting its movements.
The pericardium has two layers: the outer layer that is connected to the chest cavity and the inner layer that covers the heart. Between these two layers is a small amount of fluid that allows the heart to move freely without friction during contractions and dilations.
Pericarditis is inflammation of the pericardium. Early diagnosis and treatment are essential to avoid serious complications. These can be:
- the accumulation of fluid between the two layers of the pericardium, which can lead to limited heart function or even cardiogenic shock.
- cardiopulmonary failure due to compression of the heart.
- pericardial adhesions when the pericardium hardens or narrows, causing chronic pericarditis and heart failure.
What causes pericarditis
Pericarditis can be caused by many causes. The main ones:
- Viral infections such as the flu virus, herpes, adenovirus, enterovirus.
- Bacterial infections (tuberculosis), staphylococci, streptococci.
- Inflammation due to trauma to the chest or cardiac surgery.
- Autoimmune diseases such as systemic lupus erythematosus, rheumatic heart disease and rheumatoid arthritis.
- Allergic reactions to drugs (Antibiotics, diuretics, etc.)
- Complication from other heart disease (e.g. myocardial infarction).
- Metabolic disorders (gout, kidney failure, etc.) or other unknown cause.
Symptoms of pericarditis
- Chest pain which may be sharp or diffuse, especially when the person lies down or breathes deeply, while it subsides when sitting or leaning forward.
- Shortness of breath when there is an accumulation of fluid around the heart.
- Fever.
- Tachycardia.
- Palpitations.
- Fatigue or general weakness.
Diagnosis of pericarditis
People with the above symptoms should visit a Cardiologist.
The doctor, after taking the medical history, will perform a clinical examination with auscultation of the heart, electrocardiogram and ultrasound of the heart (Triplex). He will issue a referral for blood tests in order to investigate conditions such as increased levels of inflammatory markers (CRP, sedimentation rate, white blood cell count) that indicate the presence of inflammation in the body. He may request a CT or MRI scan in some cases, to better assess the condition.
Treatment of pericarditis
Treatment of pericarditis depends on its cause and its severity. It usually includes: Anti-inflammatory drugs to relieve pain and inflammation, corticosteroids in more severe cases, antibiotics or antivirals if the pericarditis is caused by an infection. If there is fluid accumulation or pericardial compression, pericardiocentesis may be required to remove the fluid.
