Pericardial disease or pericarditis is an inflammation of any of the pericardial layers. The pericardium is a thin, fibrous, double-walled sac that surrounds the heart and consists of:
- Fibrous layer: the most superficial pericardial layer.
- Serous layer: the inner layer which in turn is divided into visceral outer and inner parietal layers.
- Pericardial fluid: lubricating serous fluid located in the pericardial cavity between the parietal and visceral layers. It serves to reduce friction on the heart during heart contractions.
The pericardium plays an important role in protecting the heart and maintaining its proper position so that it can function properly.
Causes
In most cases, pericarditis develops as a complication of an underlying disease. Since it is an inflammatory condition, it could appear 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, and echinococci.
- Pericarditis caused by autoimmune diseases such as rheumatoid arthritis, lupus, scleroderma.
- Traumatic pericarditis that results from severe injury or trauma to the chest area. Sometimes it can develop after surgery in this area.
- Pericarditis develops due to tumors located directly in 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. In addition, the triggers for 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:
- Shooting or sharp pain in the middle or left side of the chest that may spread to one or both shoulders
- Attacks of heart palpitations
- Fever
- Fast or irregular heart rate
- Swelling of the ankles, legs, or feet.
- Dyspnoea
- Weakness or fatigue
- Dry cough
Treatment
The goals of pericarditis treatment include:
- Relieve symptoms
- Treat underlying conditions
- Preventing complications
Treatment methods and their duration are determined by the cause of the inflammation and complications, if any. Once the first symptoms of pericarditis are experienced, medical advice should be sought as soon as possible.
Complications and prognosis
In general, pericarditis is considered a disease with a benign outcome, as timely qualified treatment leads to a complete recovery in most patients. However, in rare cases, severe pericarditis can cause serious complications:
- Cardiac tamponade is caused by too much fluid building up in the pericardium. It is a dangerous condition that prevents proper heart contractions and leads to a dramatic drop in blood pressure.
- Constructive chronic pericarditis, a rare disease that takes time to develop. It causes scar tissue to form around the pericardium, making it stiff and preventing the heart from working properly.