Pericarditis facts
What is pericarditis?
The heart muscle has a tight covering that surrounds it, a lining sac called the pericardium (peri=around +cardium=heart). This sac actually has two layers. The visceral pericardium is only one cell layer thick and fits tightly onto the heart muscle. The parietal pericardium is much tougher and thicker and has fibers that tether the heart to the rib cage and diaphragm. There is a potential space between the layers, meaning that in normal situations, it has a minimal amount of fluid. However, should inflammation occur, it can fill with fluid. Inflammation of the lining of the heart is called pericarditis (itis=inflammation).
Picture of the heart in the pericardial sac.What causes pericarditis?
Pericarditis is usually from unknown causes (idiopathic). The cause may often be viral infections. Causes of pericarditis include:
Infections:
Inflammatory diseases:
Diseases that can cause generalized inflammation in other places within the body can also cause inflammation of the pericardium. Some examples include:
Metabolic illnesses:
Heart disease:
Other causes:
What are the symptoms of pericarditis?
Chest pain is the most common symptom of pericarditis.
Other symptoms may include fevers and chills, sweats, shortness of breath, and difficulty swallowing.
When pericarditis is due to infection, the symptoms tend to arise quickly while inflammation due to chronic diseases is more gradual in onset.
How is pericarditis diagnosed?
History and physical examinationThe diagnosis of pericarditis begins with the health care professional taking a history about the pain and its character. The health-care professional will perform a physical examination and ask the patient about associated symptoms. Past medical history is important, since pericarditis can be a complication of a chronic disease or a side effect of medication.
The most common physical finding that helps confirm the diagnosis of pericarditis is a pericardial friction rub. Inflammation prevents the two layers of pericardium from easily sliding against each other with each heartbeat. The inflammation causes a friction noise that can be heard with a stethoscope when listening to the heart. It is better heard when the patient leans forward, which causes the heart to shift to the front of the chest. The rub may not always be present and may come and go from hour to hour.
Diagnostic testingThe electrocardiogram (EKG or ECG) shows electrical activity of the heart. In pericarditis, there are hallmark changes that are seen and can help make the diagnosis. While an abnormal EKG is helpful in making the diagnosis, in the early stages of inflammation, the EKG may be normal. In most cases of uncomplicated pericarditis, a chest X-ray is usually normal. However, if fluid accumulates in the pericardial sac, the heart can appear larger on the X-ray.
A sound wave test of the heart (an echocardiogram or ultrasound of the heart) is very helpful in detecting and quantifying the fluid in pericarditis. The purpose of the test is to detect an accumulation of fluid in the pericardial sac, called an effusion. Although in many mild cases of acute pericarditis, there is no pericardial fluid seen with echocardiography. A variety of blood tests may be ordered depending upon the clinical situation.
Pericardiocentesis (please see below), is a procedure using a needle, is used to draw fluid out of the pericardial sac. It may be done to detect bacterial infection. This procedure can also be used to treat dangerous, severe pericarditis called pericardial tamponade.
What causes pericarditis?
Pericarditis is usually from unknown causes (idiopathic). The cause may often be viral infections. Causes of pericarditis include:
Infections:
Inflammatory diseases:
Diseases that can cause generalized inflammation in other places within the body can also cause inflammation of the pericardium. Some examples include:
Metabolic illnesses:
Heart disease:
Other causes:
What are the symptoms of pericarditis?
Chest pain is the most common symptom of pericarditis.
Other symptoms may include fevers and chills, sweats, shortness of breath, and difficulty swallowing.
When pericarditis is due to infection, the symptoms tend to arise quickly while inflammation due to chronic diseases is more gradual in onset.
How is pericarditis diagnosed?
History and physical examinationThe diagnosis of pericarditis begins with the health care professional taking a history about the pain and its character. The health-care professional will perform a physical examination and ask the patient about associated symptoms. Past medical history is important, since pericarditis can be a complication of a chronic disease or a side effect of medication.
The most common physical finding that helps confirm the diagnosis of pericarditis is a pericardial friction rub. Inflammation prevents the two layers of pericardium from easily sliding against each other with each heartbeat. The inflammation causes a friction noise that can be heard with a stethoscope when listening to the heart. It is better heard when the patient leans forward, which causes the heart to shift to the front of the chest. The rub may not always be present and may come and go from hour to hour.
Diagnostic testingThe electrocardiogram (EKG or ECG) shows electrical activity of the heart. In pericarditis, there are hallmark changes that are seen and can help make the diagnosis. While an abnormal EKG is helpful in making the diagnosis, in the early stages of inflammation, the EKG may be normal. In most cases of uncomplicated pericarditis, a chest X-ray is usually normal. However, if fluid accumulates in the pericardial sac, the heart can appear larger on the X-ray.
A sound wave test of the heart (an echocardiogram or ultrasound of the heart) is very helpful in detecting and quantifying the fluid in pericarditis. The purpose of the test is to detect an accumulation of fluid in the pericardial sac, called an effusion. Although in many mild cases of acute pericarditis, there is no pericardial fluid seen with echocardiography. A variety of blood tests may be ordered depending upon the clinical situation.
Pericardiocentesis (please see below), is a procedure using a needle, is used to draw fluid out of the pericardial sac. It may be done to detect bacterial infection. This procedure can also be used to treat dangerous, severe pericarditis called pericardial tamponade.
Source: http://www.rxlist.com
Infections:
Inflammatory diseases:
Diseases that can cause generalized inflammation in other places within the body can also cause inflammation of the pericardium. Some examples include:
Metabolic illnesses:
Heart disease:
Other causes:
Source: http://www.rxlist.com
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