Pericarditis refers to the inflammation of the
pericardium, the tough double membranous layer covering the heart which the space in between the layers are filled with serous fluid which acts as a shock absorber in protecting the heart from forceful shock or jerking. The pericardial layer of the heart functions as a barrier in limiting the motion of the mediastinum, protects the heart from infections arising from other organs, acts as a lubricating layer that prevents the dilation of the heart in cases of overloading of fluid volume.
In Pericarditis, the primary illness may develop during the various medical and surgical disorders affecting multiple organ systems in general. For instance, pericarditis may occur as a result of various cardiac surgeries and may also possibly occur a week to two months after an acute myocardial infarction episode. This condition may be acute or chronic and may be further classified as constrictive and accumulative. Moreover, this condition may also be further described as exudative or non-effusive.
Pathophysiology of pericarditis
Pericarditis may lead to an accumulation of fluid in the pericardial sac (pericardial effusion) and increased pressure of the heart which leads to cardiac tamponade. Frequent or prolonged episodes of pericarditis may also lead to the thickening and decreased elasticity of the pericardium itself or even to a point of possibly scarring the visceral and parietal pericardium. These conditions restrict the capacity to fill with blood (constrictive pericarditis). The pericardium may also become calcified when there is further restriction during ventricular filling. With less filling, the ventricles pump less blood resulting in decreased cardiac output later resulting in the clinical manifestations of heart failure. Restriction during ventricular filling causes peripheral edema and hepatic failure as well.
Clinical manifestations of pericarditis
Pericarditis may sometimes appear asymptomatic. The most common characteristic symptom of pericarditis is diffused chest pain, although pain also may be located beneath the clavicle, in the neck or in the scapular region. The pain or discomfort usually remains fairly constant and non-progressive, but it would worsen with deep inspiration and when lying down or turning from the side. It may be alleviated with a forward-leaning or sitting position.s The most common characteristic sign of pericarditis is a creaking rub heard most clearly at the left lower sternal border. Other signs include mild fever, increased lymphocyte count and anemia. Difficulty in breathing and symptoms of heart failure is also common as a result of pericardial compression.
Medical management of pericarditis
The objective of management or pericarditis are to determine the cause, administer therapy for treatment and symptom relief and detect signs and symptoms of cardiac tamponade. When cardiac output is inadequately impaired, the individual must be placed on bed rest until chest pain, fever and friction rub is alleviated. Analgesics and NSAIDS such are ibuprofen and aspirin may be prescribed for relief of pain during the acute phase of the condition. For more serious conditions, a surgical procedure known as pericardiocentesis is performed in order to remove pericardial fluid excess that causes pericarditis.