What is Pericarditis?
- The inflammation of the thin, two-layered fluid-filled sac that surrounds the heart (pericardium) is known as Pericarditis.
- This condition leads to friction between two layers when the heartbeats.
- There are three different types of Pericarditis:
- Acute Pericarditis: Inflammation develops suddenly and lasts for three weeks.
- Chronic Pericarditis: Inflammation develops in a slow process and lasts more than 6 months.
- Constrictive Pericarditis: Pericardium layer thickens and forms the scar tissue and makes the heart work normally.
- In most cases, pericarditis will be acute.
What are the causes of pericarditis?
- Viral infection: Most commonly due to gastrointestinal virus
- A bacterial infection like tuberculosis
- Fungal infection
- Infection from parasite
- Autoimmune disorders like lupus, scleroderma, or rheumatoid arthritis
- Chest injury
- Kidney failure
- Genetic diseases
- Certain medicines like phenytoin, Warfarin, heparin, or procainamide
What increases the risk of developing pericarditis?
- Thyroid problems
- Following a heart attack or heart surgery
- Following radiation therapy
- Percutaneous treatment like cardiac catheterization or radiation ablation therapy
What are the symptoms of pericarditis?
- Chest pain is a common symptom of pericarditis and may get worse when patient cough, swallow, breathe or lie flat
- Sharp and stabbing due to friction between the two layers
- Pain in the back, neck or left shoulder
- Swelling in feet, legs or ankle and abdomen
- Irregular heartbeat
- Shortness of breath
What are the complications of pericarditis?
- Cardiac tamponade: This condition is due to fluid in the pericardium that leads to improper functioning of heart and dramatic drop in blood pressure.
- Chronic constrictive pericarditis: Permanent thickening and scarring of two-layered pericardium lead to severe swelling of abdomen and legs, shortness of breath.
How is pericarditis diagnosed?
To identify the presence of fluid around the heart
To determine emergency surgical treatment
To differentiate ate a type of pericarditis involvement
- Cardiac catheterization:
To remove excess fluid(pericardial effusion) around the heart
To differentiate the type of pericarditis
To identify the blocks in blood vessels of the heart
How is pericarditis treated?
- To reduce inflammation and swelling of legs or abdomen
- Over the counter drugs like aspirin or ibuprofen
- Colchicine: To reduce inflammation during acute pericarditis. Contraindicated during liver or kidney damage
- Corticosteroids like prednisolone
- Antibiotics during pericarditis caused by a bacterial infection
- Pericardiocentesis: This procedure involves a needle or catheter to drain excess fluid in the in the pericardial cavity
This procedure involves the removal of entire pericardium by open-heart surgery for chronic constrictive pericarditis