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Diseases »  Heart and Circulation Diseases »

Pericardium Disorders

Pericardium Disorders

 The pericardium is a membrane, or sac, that surrounds your heart. It holds the heart in place and helps it work properly. Problems with the pericardium include:
·         Pericarditis - an inflammation of the sac. It can be from a virus or other infection, a heart attack, heart surgery, other medical conditions, injuries, and certain medicines.
·         Pericardial effusion - the buildup of fluid in the sac.
·         Cardiac tamponade - a serious problem in which buildup of fluid in the sac causes problems with the function of the heart.
Symptoms of pericardial problems include chest pain, rapid heartbeat and difficulty breathing. Fever is a common symptom of acute pericarditis. Your doctor may use a physical exam, imaging tests, and heart tests to make a diagnosis. Treatment depends on the cause.


INTRODUCTION

The pericardium is a membrane, or sac, that surrounds your heart. It holds the heart in place and helps it work properly. There are many disorders that can affect the pericardium. Treatment for pericardial disorders depends on the cause. Treatment may include medicines, surgery or other therapies. This health information explains common pericardial disorders. It covers symptoms of pericardial disorders, as well as treatment options.

THE PERICARDIUM AND HEART
The heart is responsible for pumping blood to all the organs in the body. It is a muscle that must work continuously, without rest, for a lifetime. The pericardium is a membrane, or sac, that surrounds the heart. It is made of 2 thin layers of tissue. Between the 2 layers is a small amount of fluid. This fluid keeps the layers from rubbing against each other and causing friction. The pericardium holds the heart in place. It also helps the heart work properly.

SYMPTOMS
Many pericardial disorders have similar symptoms. The main symptom is chest pain. The pain may feel like a heart attack. If you have chest pain, you should seek emergency medical care right away. Other common symptoms of pericardial disorders are:
  • Fast heartbeat.
  • Difficulty breathing or shortness of breath.
  • Tiredness.
Some pericardial disorders may also cause:
  • Fever.
  • Coughing.
  • Swelling in the stomach and legs.
Talk to your health care provider if you notice any of these symptoms or other changes. Finding a problem early makes treatment easier in most cases.

PERICARDITIS
In pericarditis, the layers of tissue in the pericardium become inflamed. When this happens, the tissues can rub against the heart and cause chest pain. In many cases, the cause of pericarditis is not known. Viral infections are a common cause of pericarditis. Bacterial, fungal and other infections also can cause pericarditis. Other possible causes of pericarditis include:
  • Autoimmune diseases, including ulcerative colitis.
  • Certain medical conditions, such as kidney failure, HIV/AIDS and cancer.
  • Heart attack or heart surgery.
  • Taking certain medicines.
  • Trauma to the chest.
  • Prior radiation therapy to the chest.
Pericarditis can disrupt your heart's normal rhythm or function. Rarely, it may lead to death. But most cases of pericarditis are mild. Mild cases of pericarditis may not require treatment. They may clear up on their own or with rest. Over-the-counter, anti-inflammatory medicines can help reduce pain and inflammation. Examples of these medicines include aspirin and ibuprofen. You may need stronger medicine if your pain is severe. If pericarditis is caused by an infection, you may be given an antibiotic or other medicine to treat the infection. You may need to stay in the hospital during treatment for pericarditis. This lets your health care provider monitor you for any complications. If complications happen, you may need other medical procedures or surgery. Talk to your health care provider to learn more about treatment for pericarditis.

PERICARDIAL EFFUSION
Pericardial effusion is the buildup of fluid in the pericardial sac. This causes pressure on the heart and prevents it from working properly. If left untreated, pericardial effusion can result in heart failure and death. Pericardial effusion can happen if the pericardium is diseased or injured. This causes inflammation and a buildup of fluid. In some cases, fluid can also build up around the heart without inflammation. Pericardial effusion may be caused by a buildup of blood after surgery or an injury. Other possible causes of pericardial effusion include:
  • A buildup of waste products in the blood due to kidney failure.
  • Autoimmune disorders, such as rheumatoid arthritis or lupus.
  • Radiation therapy or chemotherapy treatment for cancer.
  • Viral, bacterial, fungal or parasitic infections.
Pericardial effusion can result in cardiac tamponade. This condition happens when one or more of the heart’s chambers collapse due to a buildup of fluid. Cardiac tamponade is a life threatening condition. It happens when blood that is rich in oxygen can’t reach other areas of the body. Treatment for pericardial effusion depends on many factors, including:
  • How much fluid has built up.
  • The cause of the disorder.
  • How well the heart is working.
Treating the underlying cause of pericardial effusion often corrects the problem. Treatment can include:
  • Medicines.
  • Draining the fluid.
  • Surgery.
Anti-inflammatory medicines can help reduce inflammation of the pericardium. These medicines may be given when the heart is still working normally and not much fluid has built up. You may need to have the fluid drained if the heart is not working normally or if you have a lot of fluid built up in the pericardium. A needle is used to enter the pericardium and place a small tube called a catheter to drain fluid. This procedure is called pericardiocentesis. Sometimes open heart surgery may be needed to drain the fluid and repair any damage. Surgery may also be done to remove the pericardium if pericardial effusion happens multiple times. A procedure to seal the layers of the pericardium can also prevent pericardial effusion from happening again. This procedure is called intrapericardial sclerosis. A solution is injected into the space between the layers of pericardial tissue to seal the layers together.

DRESSLER’S SYNDROME
Dressler’s syndrome is inflammation of the pericardium that happens following heart surgery or a heart attack. Dressler’s syndrome is less common than it used to be. This is due to improved treatment for heart attacks. But once you have Dressler’s syndrome, you are more likely to get it again. Dressler's syndrome is related to an immune system response to heart tissue damage. When the heart tissue is damaged, the body reacts to the injured tissue by sending immune cells and antibodies to repair the damaged area. Sometimes the immune response can cause too much inflammation in the pericardium. This results in Dressler’s syndrome. Dressler’s syndrome can lead to serious complications. It can affect the way the heart works and cause cardiac tamponade. It can also cause scarring of the pericardium, which restricts the movement of the heart. Treatment goals for Dressler's syndrome are to manage pain and reduce inflammation. Often over-the-counter anti-inflammatory medicines are tried first. Prescription anti-inflammatory medicines are also available. These medicines may be used when over-the-counter medicines do not help. This is due to the risk of side effects after a heart attack or heart surgery. If fluid buildup in the pericardium is due to the inflammation, it may need to be drained. In some cases, the entire pericardium may need to be surgically removed to allow the heart to work normally. Some health care providers may prescribe an anti-inflammatory medicine after heart surgery to prevent Dressler’s syndrome.

SUMMARY
The pericardium is a membrane, or sac, that surrounds your heart. It holds the heart in place and helps it work properly. There are many disorders that can affect the pericardium, including:
  • Pericarditis.
  • Pericardial effusion.
  • Dressler’s syndrome.
Many pericardial disorders have similar symptoms. The main symptom is chest pain. The pain may feel like a heart attack. If you have chest pain, you should seek emergency medical care right away. You may be having a heart attack. Other common symptoms of pericardial disorders are:
  • Fast heartbeat.
  • Difficulty breathing or shortness of breath.
  • Tiredness.
Treatment for pericardial disorders depends on the cause. Treatment may include medicines, surgery or other therapies. Fluid may need to be drained from the pericardial sac. The layers of the pericardium may also be sealed together. Pericardial disorders can result in serious complications. Talk to your health care provider if you have the symptoms of a pericardial disorder or other symptoms