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Pericarditis is the inflammation of the pericardium. It is usually caused by a viral infection, but may also be triggered by a bacterial infection or some other cause. The inflammation can lead to a build-up of fluid in the pericardium. This is known as pericardial effusion and can adversely affect the heart’s pumping function. The resulting condition is called cardiac tamponade.
The pericardium is a delicate double-layered skin that surrounds the heart and features a narrow space between the layers. It enables the heart to pump smoothly within the chest cavity. Viral infections are the most common cause of pericardial inflammation. It is less frequently caused by bacterial infections. Other factors that can lead to the inflammation of the pericardium or pericardial effusion include a heart attack, immune reactions, metabolic diseases, tumours and injuries.
A serious complication that can result from pericardial effusion is a condition known as cardiac tamponade. The build-up of fluid presses the pericardium together, which has a major impact on the functioning of the heart. In such cases, urgent action is required to reduce the pressure on the heart. A possible long-term complication of pericarditis is scarring on the pericardium. This scarring can constrict the pericardium so much that the heart can no longer sufficiently expand. This condition is known as constrictive pericarditis.
Inflammation of the pericardium causes symptoms that vary in severity depending on the degree of inflammation. Sometimes patients simply feel a bit exhausted and have a mild fever. But stabbing chest pains that increase when you inhale can also indicate pericarditis. Given these non-specific symptoms, it is often difficult to differentiate this condition from other heart diseases.
Pericardial effusion with pericardial tamponade can cause shortness of breath, cyanosis, a rapid heartbeat and even lead to a state of shock.
In addition to listening to the patient’s heartbeat and carrying out a physical examination, other examinations are necessary to diagnose pericarditis or pericardial effusion. These include an ECG, echocardiography, blood tests and possibly radiological examinations like CT or MRI scans.
The choice of treatment depends on what is causing the pericarditis. Inflammation of the pericardium caused by a viral infection is treated with anti-inflammatory and pain-relieving medications. Antibiotics are used for bacterial pericarditis and inflammation caused by an immune reaction is treated with cortisone.
In the case of pericardial effusion or pericardial tamponade, the fluid must be drained as quickly as possible. This is achieved by puncturing the pericardium. Surgical treatment options involving the partial or complete removal of the pericardium come into play if a patient is suffering from chronic pericarditis or if their pericardium is scarred.