Pericarditis is the inflammation of the pericardium. The pericardium, in turn, is a sac-shaped membrane that surrounds the heart. This membrane has two layers and between them there is a small volume of liquid, which serves as a lubricant and causes the two layers to slide between them, without causing problems.
When pericarditis occurs, the volume of the fluid increases. That can end up clogging the heart, preventing its functioning. But nevertheless, in most cases there are no major problems and improvement without the need for treatment. The most serious cases require medication and only rarely, surgery.
Pericarditis mainly affects men between 20 and 50 years of age. In cases where it is impossible to treat it, the pericardium can be removed without causing consequences of consideration.
Types of pericarditis
Basically, there are two types of pericarditis: acute and chronic. Let's see the characteristics of each of them:
- Acute pericarditis. It is characterized by its sudden onset. It lasts less than six weeks and, with relative frequency, generates pericardial effusions. You have symptoms similar to those of a heart attack. Only a small percentage of patients have relapses.
- Chronic pericarditis. It arises as a result of a thickening of the pericardium or an accumulation of fluid. It lasts more than six weeks and can cause right ventricular insufficiency, that is, edema in the abdominal area, pretibial area and ankles.
Chronic pericarditis occurs when a fibrous tissue is formed around the heart.. This tissue compresses that organ and increases the pressure in the veins that carry blood to it. This causes the pericardium fluid to stagnate and, in its attempt to exit, end up accumulating in other parts of the body.
Causes of pericarditis
In 80% of cases it is impossible to establish the cause of pericarditis. However, it is very common that its origin is associated with some type of infection. The most common is that it is a viral infection. To a lesser extent, there is a base bacterial infection and only very rarely is it a fungal infection.
Likewise, there are many cases in which Pericarditis appears associated with any of the following diseases:
In other cases, the immediate antecedent is a heart attack or heart surgery, as well as trauma to the thoracic area. Sometimes, pericarditis is related to an inflammation of the myocardium, the practice of radiotherapy in the chest or the use of some drugs.
Symptoms and diagnosis
The typical symptom of acute pericarditis is severe and stabbing pain in the chest area. It sits on the left side and behind the sternum. However, there are also many people who only experience mild and constant pain. Others report feeling a pressure in the chest, with a variable intensity.
Many times, pain is also felt in the left shoulder and neck. The discomfort becomes more intense at the time of coughing, inhaling deeply or at bedtime. Instead, he manages to dilute himself a little while sitting and lean forward somewhat.
Read also: What to do when you feel chest pain?
In chronic pericarditis, chest pain is also usually the predominant symptom. In addition, both in this and in the acute Other symptoms may appear such as:
- Heart palpitations
- Slight fever.
- Swelling in the legs
- Feeling dizzy
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The milder cases of pericarditis usually resolve on their own. However, once pericarditis is detected, Most often a drug treatment is started. Usually, commonly used pain relievers are prescribed to manage pain and reduce inflammation.
It is also possible that Colchicine is prescribed, which reduces inflammation and prevents recurrent episodes. However, this drug is not safe for those suffering from liver or kidney disease, or for those taking certain medications.
When there is no response to these drugs, the measure to follow is usually to order corticosteroids. If the cause of pericarditis is a bacterial infection, antibiotics are usually prescribed to treat it.
In the most severe cases, especially if there is a suspicion of cardiac tamponade, it is appropriate to drain, by a pericardiocentesis procedure. It is rarely necessary to go to pericardiectomy, or definitive removal of the pericardium.