What is Pericardium?

June 29, 2022

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The pericardium is a thin, two-layered sac covering the heart’s outer surface. The heart pump helps to lubricate the heart, shields it from infection and malignancy, and keeps it in the chest wall. In addition, the heart muscle contracts more powerfully when blood volume increases, which helps keep the heart working efficiently.

What is Pericarditis?

Pericarditis – Inflammation of the pericardium. Pericarditis is usually short-lived, developing suddenly and lasting for a few weeks to a month. The condition usually improves after three months but sometimes develops and lasts for years. This is like the skin around a cut that becomes inflamed. In addition, there can be fluid accumulation in the space between the pericardial layers, known as pericardial effusion. Pericarditis is a condition that affects anyone but is most common in men aged 16 to 65.

Pericarditis typically starts quickly and lasts for a short time – this is known as acute pericarditis. However, if pericarditis lasts for a more extended period, it is considered chronic pericarditis.

Types of Chronic Pericarditis

Incessant: This type of illness typically occurs within six weeks of weaning off of medical treatment for acute pericarditis.
Intermittent: After reducing medical treatment for acute pericarditis.

Symptoms of Pericarditis

People with pericarditis have chest pain as a symptom. This can feel like a heart attack, with sudden and sharp pain in your chest. Pain spreads to your shoulders, neck, arms, or jaw.

Sharp pain in the chest, sometimes central, other times to the left, that may decrease in intensity when sitting up and leaning forward
Palpitations
Shortness of breath, especially when reclining
Minor fever
General weakness
Swelling of the abdomen or legs
Cough
Pain in the shoulder

Causes of Pericarditis

The pericardium, or pericardium, consists of two layers separated by a small amount of fluid. This fluid helps the two membranes move smoothly together. If the pericardium becomes infected and expands, the two layers of the pericardium will come into contact, causing friction.

In many cases, the primary cause of pericarditis cannot be identified. Pericarditis is an illness that is not understood and is known as idiopathic. Many cases are caused by viral infections that cannot be detected.

The following viruses are associated with acute pericarditis:

Enteroviruses, including the common cold and viral meningitis
HIV
Glandular fever
Herpes simplex
Cytomegalovirus
Adenoviruses, including pneumonia and bronchitis
Influenza
Hepatitis C

Pericarditis is often a complication that arises after a significant heart attack. This may be due to irritation of the heart muscles. It is a condition in which the pericardium becomes inflamed.

Pericarditis may develop weeks after a heart attack or operation, called Dressler’s syndrome. It is a disorder that affects the way your skin and hair growth. In this case, the cause may be autoimmunity.

Other causes of pericarditis include:

Systemic inflammatory diseases, including rheumatoid arthritis or lupus
Trauma
Kidney failure
Parasite
Radiotherapy
Fungi such as Histoplasmosis and Candida
Underlying diseases such as AIDS, cancer and tuberculosis
Underactive thyroid
Certain medications, including penicillin, warfarin, and phenytoin

Types of pericarditis

Acute Pericarditis: This is the most common form of the condition. It can happen on its own or as a sign of an underlying health problem.
Recurring or Relapsing Pericarditis: Recurrent pericarditis is an illness characterised by repeated episodes of inflammation of the pericardium, which is the sac that contains the heart.
Chronic Pericarditis occurs when relapse occurs as soon as a person stops taking anti-inflammatory medication.
Pericardial effusion: This is an accumulation of fluid in the pericardium layers. This can lead to fluid build-up in the heart, called cardiac tamponade.
Cardiac Tamponade: Cardiac tamponade is a severe condition in which blood or fluids fill the space between the sac around the heart and the heart muscle.
Delayed Pericarditis: This can happen when the pericardium (a sac around the heart) scars or becomes stuck to the heart, preventing the heart muscle from expanding. This condition is rare and can occur in patients with chronic pericarditis or after cardiac surgery.

Diagnosis of Pericarditis

Your doctor will ask about your medical history, what symptoms were when they began, and what makes them worse. Then, the doctor will listen to the patient’s chest. When the layers of the pericardium rub against each other, they can produce a distinctive sound.

Other tests used in diagnosis include:

Chest x-ray, which produces pictures of your heart and possible excess fluid.
An electrocardiogram (EKG or EKG) to check your heart rhythm.
Echocardiogram to assess the shape and size of your heart and the presence of fluid accumulation.
CT and MRI, which give a detailed view of your pericardium.
Right heart catheterisation provides pressure information filling in your heart.
Blood tests to look for markers of inflammation.

Procedures for Pericarditis

Suppose medications don’t seem to be working. In that case, other surgical options may include pericardiocentesis, which is a procedure where a small tube is inserted into the pericardial cavity to remove excess fluid. The tube may be inserted for a few days.

Pericardiectomy: Surgery may be done to remove the entire sac if the pericardium becomes particularly stiff and causes extra pressure on the heart. This is a risky procedure that is only used in cases of extreme need.