Pericardial Diseases

Overview

Pericardial disease refers to the group of conditions that affect the pericardium. The pericardium is a double-layered sac that covers your heart. This sac protects the heart from infection and keeps the heart from getting too large when blood volume is high.

• Pericarditis: Pericarditis is defined as inflammation of the pericardium. This condition is usually acute and may last up to several months.

• Constrictive Pericarditis: Constrictive pericarditis occurs when the pericardium becomes thickened and scarred. This makes it very difficult for the heart to expand with blood.

*Pericarditis can be acute (occurring suddenly) or chronic (long-standing)

Symptoms

While not always present, symptoms of pericarditis may include:

• Chest pain
• Low-grade fever
• Increased heart rate

Constrictive pericarditis will be accompanied by all the same symptoms, with the addition of the following:

• Shortness of breath
• Fatigue
• Signs of heart failure (swelling of legs and feet, weight gain)
• Atrial fibrillation (irregular heartbeat)

Chronic pericarditis is usually associated with fluid around the heart (pericardial effusion). If you begin experiencing chest pain, seek medical care immediately.

Causes & Risk Factors

Causes of pericardial disease, specifically pericarditis are:

• Prior heart surgery
• Heart disease or prior heart attack
• Cancer
• Radiation
• Autoimmune diseases (rheumatoid arthritis, lupus, scleroderma)
• Although unusual, some medications can cause pericarditis

Diagnosis

After taking a detailed medical history, your doctor will then conduct a thorough physical exam and assess your symptoms. If you are a likely candidate for pericarditis, your doctor may use your blood work and the one or more of the following tests to diagnose your condition:

Treatment

Once a diagnosis has been reached, your doctor will build an individualized treatment plan aimed at the cause of your pericarditis. The severity of your condition also plays a large role in treatment as mild cases of the disorder usually resolve themselves without treatment.

If your doctor determines that your pericarditis requires treatment, you will likely undergo some combination of the following:

• Medication to reduce the inflammation associated with pericarditis and chest pain symptoms.

• Pericardiocentesis to remove excess fluid that has accumulated in the pericardial cavity.

• Pericardiectomy: In cases of severe chronic pericarditis, the pericardium can hinder your heart’s ability to pump. In these cases, it may be necessary to remove the entire pericardium in order to ensure optimal cardiac functioning.