Pericardial disease or pericarditis is an inflammation of any of pericardial layers. Pericardium is a thin double-walled fibroserous sac that surrounds the heart and consists of:
- Fibrous layer — the most superficial pericardial layer.
- Serous layer — the inner layer which in its turn is divided into outer parietal and internal visceral layers.
- Pericardial fluid — the lubricating serous fluid located in the pericardial cavity between the parietal and visceral layers. It serves to reduce the friction of the heart during cardiac contractions.
Pericardium performs an important function by protecting the heart and maintaining its adequate position so that it could work properly.
In most cases pericarditis develops as a complication of an underlying disease. Since it’s an inflammatory condition, it might seem that it could be the consequence of an infectious disease. However, there are different types of pericarditis depending in its cause:
- Pericarditis caused by viral, bacterial, parasitic or fungal infections. The most common infectious organisms include streptococcus, Epstein-Barr virus, Candida fungi, toxoplasma, echinococcus.
- Pericarditis provoked by autoimmune diseases such as rheumatoid arthritis, lupus, scleroderma.
- Traumatic pericarditis that results from severe injuries or trauma in the chest area. Sometimes it can develop after a surgical intervention in this area.
- Pericarditis developing due to tumors located directly on the pericardial layers or in the adjacent areas.
- Pericarditis associated with serious metabolic disorders such as Addison’s disease.
The most common causes of pericarditis include rheumatism and tuberculosis. Besides, the provoking factors for pericarditis are myocardial infarction, endocarditis, allergic reactions, and radiation therapy.
Since this pathology usually develops as a complication of other diseases, it lacks specific clinical symptoms; however, depending on the type, pericarditis symptoms include any of the following:
- Piercing or sharp pain in the middle or left side of the chest that can spread to one or both shoulders
- Attacks of heart palpitations
- Fast or irregular heart rate
- Swelling of ankles, legs or feet
- Weakness or fatigue
- Dry cough
The goals of pericarditis treatment involve:
- Relieving symptoms
- Treating the underlying conditions
- Preventing complications
Treatment methods and its duration are determined by the cause that provoked inflammation and complications, if any. Once experiencing first symptoms of pericarditis, one should seek medical advice as soon as possible.
Complications and prognosis
In general, pericarditis is considered a disease with a benign outcome since timely qualified treatment leads to a complete recovery in the majority of patients. However, in rare case severe pericarditis can cause serious complications:
- Cardiac tamponade is caused by too much fluid being collected in the pericardium. It’s a dangerous condition that prevents adequate cardiac contractions and leads to a dramatic decrease in blood pressure.
- Chronic constructive pericarditis, a rare disease that needs time for development. It causes the formation of scar-like tissue throughout the pericardium, which makes it stiff thus preventing the heart from functioning properly.