Pericarditis

The pericardium is made up of two layers of thin tissue (membrane) that contain fluid. The fluid allows the layers to glide smoothly over each other when the heart beats.

The pericardium helps keep the heart in place and protects it.

When the pericardium becomes inflamed, this is called pericarditis. The inflammation causes the membrane layers to swell and rub against each other as the heart contracts and relaxes.

, shortness of breath and palpitations. It is always important to seek medical help as soon as possible if you experience these symptoms. Pericarditis is usually mild and can be managed with rest and medicines, if needed.

Depending on the type of pericarditis you have, symptoms can vary and can include:

• palpitations or a racing heart
• which can be a sign of an abnormal heart rhythm. Symptoms of acute pericarditis can last from one to three weeks

Chronic pericarditis lasts three months or longer

The cause of your pericarditis may not always be clear.

Causes of pericarditis include: radiation therapy

caused by a virus can lead to pericarditis

You may be prescribed medicines to help reduce the inflammation and to relieve pain. is potentially fatal, so it is very important to seek medical treatment as soon as possible. Most cases of bacterial pericarditis are caused by infections somewhere else in the body.

For example, if you have bacterial (a lung infection), you may develop pericarditis if the bacteria in your system infects the pericardium directly or through your bloodstream. Seeking medical help as soon as possible to treat infections (such as pneumonia) for example, will help reduce the chance of developing bacterial pericarditis.

As the pericardium recovers from injury or inflammation, scar tissue may form.

Scar tissue makes the pericardium less flexible, so the heart can’t beat properly and pump blood around the body as it should. Symptoms of constrictive pericarditis can include: Without treatment, constrictive pericarditis can lead to complications including: The injury to heart tissue caused by a heart attack can sometimes lead to pericarditis.

This is known as post-heart attack (or post-myocardial infarction) pericarditis.

The symptoms of pericarditis may not appear for some weeks or months after the heart attack.

Pericarditis may rarely occur after heart surgery

Certain heart surgeries involve opening the pericardium, including and heart valve surgery. Pericardial thickening or scarring can happen after heart surgery and this can contribute to pericarditis after surgery. Long-term inflammation causes a gradual build-up of fluid within the two layers of the pericardium.

In most cases, the reasons for this are unknown. Two of the known causes of chronic effusive pericarditis are tuberculosis and To diagnose pericarditis, your doctor will ask about your medical history and do a physical examination. Your doctor will listen to your heart with a stethoscope.

A stethoscope is typically placed on the chest and back to listen to heart sounds.

Pericarditis causes a specific sound, called a pericardial rub

The noise occurs when the two layers of the sac surrounding the heart (pericardium) rub against each other if the pericardium is inflamed.

Your doctor may also organise some tests including: taking a sample of pericardium fluid (using a fine needle) that will be examined in a laboratory. Treatment for pericarditis depends on the cause and severity, but may include:

• limiting physical activity if necessary. This can help limit the strain on your heart
• prevent or limit damage to your heart muscle medicines to reduce inflammation
• such as colchicine
• in some cases
• non-steroidal anti-inflammatory medicines (NSAIDS) or corticosteroids – if your doctor decides they are necessary antibiotics – if your pericarditis is caused by a bacterial infection

If pericarditis causes fluid build-up around the heart, a surgery or other procedure may be needed to drain the fluid. Surgeries or other procedures to treat pericarditis include:

• . In this procedure
• a sterile needle or a small tube (catheter) is used to remove
• drain the excess fluid from around the heart

The entire pericardium may need to be removed if the sac surrounding the heart is permanently stiff due to constrictive pericarditis.

This surgery is only rarely required

Some of the complications of pericarditis include:

• e – this can happen when more fluid than usual builds up between the two layers of the pericardium. The heart is compressed
• can’t pump properly. This requires urgent medical attention
• left untreated can be fatal

– as with any infection, the infection in the pericardium can spread to other parts of the body and infect the blood. About pericarditis The heart The symptoms of pericarditis can be similar to those of a heart attack and can include chest pain Symptoms of pericarditis sharp and stabbing chest pains pain radiating into the left shoulder and arm pain that gets worse if you’re lying down or taking deep breaths a fever sweating and chills feeling short of breath or trouble breathing dizziness feeling faint dry cough Causes of pericarditis viral infection bacterial infection heart attack chest injury heart surgery kidney failure autoimmune diseases, such as rheumatoid arthritis or systemic lupus erythematosus cancer Viral pericarditis A viral infection is the most common cause of pericarditis.

For example, a chest infection Bacterial pericarditis Pericarditis caused by a bacterial infection pneumonia Constrictive pericarditis fatigue feeling short of breath or trouble breathing dizziness feeling faint swelling of the abdomen or lower legs (due to fluid build up) heart palpitations (due to an abnormal heart rhythm) abnormal heart rhythm (heart arrhythmia) heart failure liver damage Post-heart attack pericarditis Pericarditis after heart surgery coronary artery bypass graft surgery Chronic effusive pericarditis hypothyroidism (underactive thyroid gland) Diagnosis of pericarditis blood tests an electrocardiogram (ECG) a chest X-ray an echocardiogram (ultrasound of the heart) a heart computerised tomography (CT) scan magnetic resonance imaging (MRI) scan of the chest Treatment for pericarditis medicines for pain relief Surgeries and other procedures Pericardiocentesis Removal of the pericardium (pericardiectomy) Complications of pericarditis cardiac tamponad abscess – this is a build-up of pus either within the heart or in the pericardium spread of infection Where to get help Your GP (doctor) In an emergency, always call 911 NURSE-ON-CALL (616) 555-0024 – for expert health information and advice (24 hours a day, 7 days a week).

Key Points

• inflammation causes the membrane layers to swell and rub against each other as the heart contracts and relaxes
• always important to seek medical help as soon as possible if you experience these symptoms
• Symptoms of acute pericarditis can last from one to three weeks
• cause of your pericarditis may not always be clear
• Causes of pericarditis include: radiation therapy