What is Pericarditis (Inflammation of the Heart Membrane)? Symptoms, Causes, Diagnosis, and Treatment Methods

What is Pericarditis (Inflammation of the Heart Membrane)? What Are the Symptoms?

Pericarditis is the inflammation of the pericardium, the sac surrounding the heart. In this disease, which often manifests with chest pain, heart movements can be restricted. It may occur as a result of viral infections or certain medical conditions. Treatments may vary depending on the factor causing the disease and the patient's condition.

What is Pericarditis (Inflammation of the Heart Membrane)? What Are Its Types?

The pericardium is a thin, two-layered, fluid-filled sac that surrounds the exterior of the heart. The inflammation of this sac is called pericarditis. There are many types of this disease. These types can be classified according to symptoms and causes. Types based on symptoms are as follows:

Acute pericarditis: Begins suddenly and manifests with direct symptoms. The symptoms experienced may last for 3 months or less. Recovery is usually achieved in a short time with proper treatment.

Chronic pericarditis: It is called chronic if it lasts for 3 months or longer after acute symptoms appear.

Recurrent pericarditis: This is the name given to repeated attacks. It exhausts the patient. Therefore, compliance with the treatment stages is necessary.

Types based on causes are as follows:

Constrictive pericarditis: The inflamed layer of the pericardium hardens and thickens. Because of this, it is a type where symptoms are experienced severely.

Viral pericarditis: Develops as a result of a bacterial, viral, or parasitic infection.

Uremic pericarditis: Occurs as a result of kidney failure.

Malignant pericarditis: May occur with cancer that has spread to the body.

Traumatic pericarditis: May develop as a result of a blow to the chest in a car accident.

Idiopathic pericarditis: The type with no known cause.

What Are the Symptoms of Pericarditis?

Symptoms of pericarditis may vary depending on the type of the disease and from patient to patient, but chest pain is frequently seen in this condition. The pain may be sharp and stabbing, and it may worsen during coughing, swallowing, or taking a deep breath. Patients often lean forward when pain occurs to help relieve it. Other symptoms of pericarditis include:

Fever,

Fatigue,

Tachycardia (rapid pulse),

Dry cough,

Difficulty breathing while in a reclining position,

Pain in the back, neck, and left shoulder,

Swelling of the legs, feet, and ankles.

Swelling in the legs, feet, and ankles is a serious symptom and is seen in pericardial hardening. When hardening occurs, the heart cannot expand sufficiently, and therefore tachycardia may occur. If you or someone around you is experiencing any of these symptoms, it is necessary to make an appointment at a healthcare institution for an examination.

How Does Pericarditis Occur?

There are many factors among the causes of pericarditis, but the cause in many patients may not be determined. Conditions that can play a role in the development of pericarditis include:

Viral infection: Any virus, such as Sars-Cov-2 or gastrointestinal viruses, can cause inflammation in the heart membrane.

Bacterial infection: Infections caused by bacteria can lead to pericarditis. Tuberculosis disease can be given as an example of this.

Genetics: Diseases related to genetics, such as Familial Mediterranean Fever, can lead to the development of the disease.

Trauma: A car accident is an example of trauma; if a chest injury occurs during the accident, traumatic pericarditis may develop.

Medications: Although rare, medications that have an immunosuppressive effect can contribute to the development of the disease.

Cancer: Cancers such as lung, breast, and lymphoma can cause the disease to develop.

Autoimmune disease: In lupus disease, the immune system attacks harmless cells in the body.

Rheumatic diseases: It may arise as a result of rheumatic diseases such as rheumatoid arthritis and fibromyalgia.

In addition to all these reasons, patients who have previously had a heart attack, undergone open-heart surgery, have hypothyroidism (underactive thyroid gland), or have received radiation therapy are more likely to contract pericarditis.

How is Pericarditis Diagnosed?

When you are examined for pericarditis, your doctor will want to obtain information about the course of the pain and other symptoms. They may also listen to the heart with a stethoscope. When pericarditis is listened to, a friction rub sound is heard. This sound is heard better when the patient leans forward, holds their breath, or exhales. Depending on the condition of the inflammation, sounds may also be heard from the lungs. This sound means there is too much fluid in the pericardium. Aside from this examination, there may be tests your doctor will want to perform. The tests that can be performed are as follows:

Blood tests: Heart attacks and pericarditis can be confused. Blood tests can check whether the patient has had a heart attack. At the same time, certain values will be higher than normal in a patient with pericarditis.

Chest X-ray: Can be performed to see the size of the heart and fluid in the lungs.

ECG: An ECG can be taken to check if there is any change in the heart's rhythm.

Echocardiogram (ECHO): Can be performed to see if there is fluid around the heart or to examine the heart in detail. A thickened pericardium is seen with this test.

Cardiac MRI: Helps investigate the presence of extra fluid or thickening in the heart membrane.

Computed tomography: Checked for the presence of inflammation, fluid, or tumors in the pericardium.

How is Pericarditis Treated?

Pericarditis can mostly be treated with medication, but in a situation such as fluid accumulation, the fluid may need to be drained. In medical treatment, medications can be prescribed for pain and inflammation. Depending on the cause, antifungals or antibiotics may also be required. If symptoms have persisted for a certain period, the doses of medications may be increased. To prevent side effects from dose increases, appropriate protective medications can be prescribed.

The accumulation of fluid in the pericardium is called pericardial effusion. If this fluid accumulation occurs rapidly, it can compress the heart and hinder the heart's normal working routine. In this way, a drop in blood pressure can be experienced. In addition to the drop in heart pressure, a life-threatening pressure called cardiac tamponade can occur. In such a case, intervention should not be delayed.

The procedure of removing excess fluid from the pericardium is called pericardiocentesis. While this procedure is performed, computed tomography is used to ensure correct placement. If the fluid removed by pericardiocentesis is insufficient, another procedure called a pericardial window can be applied. During a pericardial window, a small incision is made in the chest to create an opening on the pericardium. In patients with the constrictive pericarditis type, removing a part of the pericardium may also be necessary. This surgery is called pericardiectomy and is generally applied to patients who have developed scar tissue in the heart membrane.

Frequently Asked Questions About Pericarditis

Pericarditis is a disease that can affect people of all ages, but it can be seen more frequently in men between the ages of 16 and 65. At the same time, patients who have received treatment for acute pericarditis also have a high probability of having recurrent pericarditis. Kidney failure and tuberculosis patients may also have an increased likelihood of contracting this disease. Pericarditis may occur during seizures, in blood clots, and after the use of heart rhythm-regulating drugs. If pericarditis progresses, life-threatening problems can arise. Conditions that may occur include:

Pericardial effusion: This condition affects heart contractions and can lead to heart failure.

Constrictive pericarditis: Can develop when pericarditis progresses and negatively affects the normal functioning of the heart.

Cardiac tamponade: This is a condition where pressure forms as a result of fluid accumulation. It restricts the heart's functions by preventing filling and emptying. Symptoms in cardiac tamponade may include: sharp pain in the chest, difficulty breathing, fainting, dizziness, paleness of the skin color, palpitations, and tachycardia (rapid pulse).

Heart failure: As the disease progresses, the heart muscle may weaken. Heart failure may develop because it cannot pump enough blood when weakening occurs. Heart failure means that every cell in the body does not receive enough oxygen. It shows similar symptoms to other heart conditions.

All these side effects reduce the quality of patients' lives and are life-threatening. Therefore, if you are experiencing symptoms of pericarditis, it is recommended that you apply to a healthcare institution to be examined. During pericardiectomy surgery, the patient is given anesthesia and put to sleep. In this surgery, an incision is made parallel to the top of the breastbone. All or a large part of the pericardium is removed. This surgery can take several hours. After surgery, as the effect of anesthesia begins to wear off, the patient regains consciousness. All vital signs are continuously monitored after the procedure. At the same time, there may be a tube draining fluid in the chest. Your doctor may tell you to stay in the hospital for a few days after surgery. After leaving the hospital, you need to come back for an examination at the time specified by your doctor. During this examination, stitches are removed and your condition is checked. Pain mostly appears rapidly and like a stabbing pain in the chest. This pain can be experienced in the middle or left side of the chest and in the shoulders. Pericarditis can lead to heart failure. Especially in patients with the constrictive type, both right and left heart failure can be experienced. If you suspect you have pericarditis, you can make an appointment with a cardiologist to be examined. When left untreated, pericarditis can lead to negative conditions such as arrhythmias, heart failure, and liver damage. Additionally, high blood pressure and diabetes may also appear. Therefore, if you or someone around you is experiencing symptoms, it is recommended to be examined by a specialist doctor and start treatment.

Do not be late if you are experiencing symptoms of pericarditis. You can make an appointment with our Hisar Hospital Cardiology specialists for a detailed examination and create your personalized treatment plan. Take a step for your health today!