What is Pericarditis?
Pericarditis is the medical condition which causes the thin and sac-like membrane surrounding the heart – the pericardium – to become irritated and swollen. This results in a severe chest pain and other similar discomforting symptoms.
The pain in the chest is caused when the irritated layers of the pericardium rub against each other. This condition is mostly temporary and originates suddenly. In case the symptoms are severe and constant then the pericarditis is considered to be chronic.
What are the signs and symptoms of Pericarditis?
Acute form of pericarditis mostly lasts for around a few weeks. The chronic recurrent pericarditis has mainly 2 types.
In case of acute pericarditis, the most commonly seen symptom is the sharp and severe pain in the chest, right behind the breast-bone, or in the left side of the chest. Some cases of acute pericarditis may experience the pain as a dull ache, or a pressure on the chest, and the intensity of the feeling may also vary.
The pain from the chest may also travel to the left shoulder and the neck as well. It can intensify when the patient coughs, lies down or inhales deeply. Leaning forward, or sitting up, can help to relieve the pain temporarily.
It can often get difficult to distinguish the pain in the chest felt due to pericarditis and a heart attack hence it is highly advised to consult a doctor/physician in case this is felt.
Chronic pericarditis is mostly associated with chronic swelling which may also result in the accumulation of fluid around the heart (pericardial effusion). Again, chest pain is the most common symptom in this condition as well.
How is Pericarditis diagnosed?
These are some of the signs of pericarditis:
- Sharp, piercing pain in the chest in the center or the left hand side of the chest
- Shortness of breath when lying down
- Heart palpitations
- Low fever
- Fatigue
- Cough
- Abdominal/leg swelling
What are the causes of Pericarditis?
Normally, the pericardial sac around the heart has a small amount of lubricating fluid between its two layers. In pericarditis, the sac becomes swollen and the resulting friction from the swollen sac results in chest pain.
It is often hard to determine the exact cause of pericarditis and in most cases, doctors might not be able to identify the exact cause of this condition.
This condition may also be seen shortly after a severe heart attack, as a result of the irritation of the underlying damaged heart muscles.
Other causes of pericarditis may include:
Systemic inflammatory disorders – These may include rheumatoid arthritis or lupus.
Trauma – An injury to the heart (chest) may also result in pericarditis due to an accident.
Other health issues – These include kidney failure, tuberculosis, AIDS and cancer.
Certain medications – Certain medications may rarely cause pericarditis.
The initial test for pericarditis usually includes a complete physical examination including your medical history. The doctor may perform some simple tests to identify the presence of the peculiar pericardial rub noise.
The doctors may also perform tests to disqualify a heart attack as the reason for having the intense chest pain. These tests will also help to identify the accumulation of fluid in the pericardial sac as well as for signs of inflammation and bacterial infections.
These are some common diagnostic tests to identify pericarditis:
Electrocardiogram (ECG) – This requires attaching a set of electrodes to the chest in order to measure the electrical impulses given out by the heart as it pumps the blood with every beat.
Chest X-Ray – This test is useful in studying the size and the shape of the heart to check for any form of irregularity or abnormality.
Echocardiogram – This test uses high-frequency sound waves to create an image of the beating heart with its structures in detail.
Computerized tomography (CT) Scan – This technique uses x-rays to produce a detailed and magnified image of the heart and the pericardium.
Cardiac MRI – This technique uses magnetic waves and radio waves to create a clear and detailed image of the cross-section of the heart.
There are several methods of treatment for pericarditis and the specific type of treatment for the individual case depends on various factors, such as the cause and the severity of the condition. Mostly, milder cases of pericarditis tend to improve on their own.
These are the treatment methods commonly used to treat pericarditis:
Medications
These are mainly used to reduce the symptoms, such as the swelling and inflammation, which can include certain over-the-counter medications like painkillers and anti-inflammatory medications. Corticosteroids may also be used in more severe cases of pericarditis to reduce the swelling and inflammation from the pericardial sac.
Surgery
Hospitalization is required if the pericarditis is of the cardiac tamponade type, which results due to the excess fluid accumulation around the heart.
In case of cardiac tamponade the doctor may require to perform the pericardiocentesis procedure, or in most severe cases the doctor may also suggest removal of the pericardium using a pericardiectomy procedure.
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