Pericardial disease or pericarditis is an inflammation of any of the pericardial layers. The pericardium is a thin, double-walled fibroserous sac that surrounds the heart and consists of:
- Fibrous cap: the most superficial pericardial layer.
- Serous layer: the inner layer which in turn is divided into outer parietal and inner 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.
The pericardium plays an important role in protecting the heart and keeping it in its proper position so it can function properly.
Causes
In most cases, pericarditis develops as a complication of an underlying disease. Since it is an inflammatory condition, it might seem that it could be the consequence of an infectious disease. However, there are different types of pericarditis depending on its cause:
- Pericarditis caused by viral, bacterial, parasitic, or fungal infections. The most common infectious organisms include streptococci, Epstein-Barr virus, Candida fungi, toxoplasma, echinococci.
- Pericarditis caused by autoimmune diseases such as rheumatoid arthritis, lupus, scleroderma.
- Traumatic pericarditis resulting from severe injury or trauma to the chest area. Sometimes it can develop after surgery in this area.
- Development of pericarditis due to tumors located directly in the pericardial layers or in adjacent areas.
- Pericarditis associated with severe metabolic disorders such as Addison’s disease.
The most common causes of pericarditis include rheumatism and tuberculosis. Also, the factors that provoke pericarditis are myocardial infarction, endocarditis, allergic reactions and radiation therapy.
Symptoms
Since this pathology usually develops as a complication of other diseases, it lacks specific clinical symptoms; however, depending on the type, symptoms of pericarditis include any of the following:
- Stabbing or sharp pain in the middle or left side of the chest that may spread to one or both shoulders
- Heart palpitations attacks
- Fever
- fast or irregular heartbeat
- Swollen ankles, legs, or feet
- dyspnoea
- weakness or tiredness
- dry cough
Treatment
The goals of pericarditis treatment include:
- Relieve symptoms
- Treatment of underlying conditions
- Prevention of complications
Treatment methods and their duration are determined by the cause that provoked the inflammation and complications, if any. Once the first symptoms of pericarditis are experienced, a doctor should be consulted as soon as possible.
Complications and prognosis
In general, pericarditis is considered a benign disease, since timely and qualified treatment leads to complete recovery in most patients. However, in rare cases, severe pericarditis can cause serious complications:
- Cardiac tamponade is caused by the accumulation of too much fluid in the pericardium. It is a dangerous condition that prevents proper heart contractions and leads to a dramatic drop in blood pressure.
- Chronic constructive pericarditis, a rare disease that takes time to develop. It causes scar-like tissue to form throughout the pericardium, making it stiff and preventing the heart from working properly.