What is Pericarditis?

Pericarditis refers to the swelling of the pericardium, a dual-layered membrane that surrounds the heart and its major blood vessels. A small quantity of clear, yellowish fluid, ranging from 15 to 50 milliliters, is trapped between these layers, aiding in reducing friction for smoother heart movements.

Identifying the Causes and Risk Factors

  • Infectious Pericarditis: This type results from viral or bacterial infections.
  • Non-Infectious Causes: Factors such as heart attacks, chest injuries, arterial ruptures near the heart, thoracic cancer, chest radiation, and more.
  • Autoimmune-Related Pericarditis: Conditions like systemic lupus erythematosus (SLE), rheumatic fever, and rheumatoid arthritis can trigger pericarditis.

Symptoms to Watch For

  • Primary Symptoms: Sharp or tight chest pain, especially on the left side, which might extend to the neck, shoulders, and left shoulder blade. Pain often intensifies during inhalation or when lying down, but may ease upon leaning forward.
  • Additional Signs: Fever, general weakness, breathing difficulties or rapid breathing, coughing, and heart palpitations.
  • Chronic Pericarditis Indicators: In advanced stages, one might notice abdominal swelling, leg edema, and low blood pressure, even in the absence of earlier symptoms.

Patient History Considerations

  • Past incidents of respiratory infections or colds.
  • Previous heart attack or chest injuries.
  • Other relevant medical history.

Physical Examination Insights

A physician will listen for specific heart sounds using a stethoscope. These sounds, resulting from pericardial friction, are more prominent in the early stages of the condition and might fluctuate over time.

Diagnostic Procedures

  • Electrocardiogram (EKG): To observe the heart's electrical activity for signs of pericarditis.
  • Chest X-Ray: Can reveal an enlarged heart shadow or vessels, indicating fluid accumulation.
  • Ultrasound Examination: Useful for detecting pericardial fluid.
  • CT and MRI Scans: These are highly effective in diagnosing the condition precisely.
  • Blood Tests: Helpful in distinguishing the various causes of pericarditis and confirming if it's linked to a heart attack or infection.

Treatment Approaches

  • Initial focus on reducing chest pain and heart inflammation.
  • Home rest may be recommended initially.
  • Antibiotic treatment for infection-related cases.
  • Draining excess pericardial fluid using a needle and tube if necessary.
  • Surgical intervention might be required for chronic cases with thickened pericardium and plaque formation, to restore normal heart function.

Possible Complications

Excessive fluid accumulation around the heart can increase pressure, hindering proper heart filling, leading to low blood pressure and potentially shock. This is a critical emergency requiring immediate medical attention.

Prevention and Management for Pericarditis

While acute pericarditis is not preventable, prompt treatment and adherence to medical advice can resolve the condition and prevent chronic inflammation and complications.