Pericarditis is a life-threatening condition that requires multidisciplinary care. Its management requires an interprofessional team, including a cardiologist, radiologist, infectious disease specialist, primary care provider, and nurse practitioner. Patients usually present with vague chest pain. The condition can be mistaken for other conditions, such as angina, pleurisy, or heart attack.
Chronic constrictive pericarditis
A thorough examination of the heart is essential to diagnose pericarditis. For example, a chest MRI or CT scan can reveal thickening of the pericardium or blood clots. Other tests include cardiac catheterization, which inserts a thin tube into the heart through the groin or arm and collects blood or tissue for biopsy. An electrocardiogram, which measures electrical impulses within the heart, may also reveal constrictive pericarditis. Finally, an echocardiogram can be performed to create a picture of the heart using sound waves.
Chronic constrictive pericarditis is a chronic condition caused by fibroinflammatory changes in the pericardium, the membrane surrounding the heart. The pericardium can become thickened or irritated due to trauma, tuberculosis, prior surgery, or radiation to the heart. The pericardial layer may also become inflamed from a viral infection.
Surgical treatment of chronic constrictive pericarditis depends on the cause of the condition and whether the disease is idiopathic or tuberculous in origin. The procedure is carried out under general anesthesia and requires a chest incision. The surgeon may remove a portion or the entire pericardium.
Chronic constrictive pericarditis is a rare, chronic condition that limits the amount of blood pumped by the heart with each heartbeat. This causes the blood to back up and accumulate in the vascular system, causing edema and fluid retention. The condition usually begins gradually and does not present symptoms immediately. Sometimes, people may write it off as “old age.” But over time, the symptoms may become severe enough to alert medical professionals that they have a serious condition.
Cancer
Cancer of the pericardium usually presents as an enlarged cardiac silhouette on a chest radiograph. It may also be present as a fluid-filled effusion or a result of another organ’s metastasis. This cancer usually has a poor prognosis. The most common cancers that involve the heart and pericardium include lung and breast cancers and melanoma. Pericardial effusions are caused by tumor infiltration of the mediastinum and radiotherapy-induced fibrosis.
Treatment of pericarditis should be based on a diagnosis of neoplastic pericardial disease and any underlying cardiac complications. Specific therapy for pericarditis should be tailored to the patient’s age and overall health, the disease volume, comorbidities, and response to antineoplastic therapies. It is also essential to involve a team of physicians skilled in palliative care. The disease typically has a poor prognosis, but earlier treatment can improve the patient’s comfort and reduce the severity of symptoms.
Cancer of the pericardium is uncommon in healthy people, but it does occur in certain circumstances. Primary pericardial tumors are sporadic and are primarily caused by lymphatic spreading or invasion of the heart. They are more common in patients with advanced lung cancer, breast cancer, and malignant melanoma, as well as lymphomas and leukemia. There are also some rare cases of pericardial effusion due to chemotherapy drugs.
If you have pericardial cancer, the first thing you should do is consult a specialist. A specialist in this field can help you get an accurate diagnosis and provide you with a comprehensive treatment plan.
Viruses
Viruses are the most common cause of pericarditis. They can cause severe damage to the heart and can interfere with its function. The inflammation caused by a virus may be temporary or chronic, requiring treatment for a more extended period. Symptoms of pericarditis can include frequent chest pain. While viral infections cause 90% of cases, the exact cause is unknown in more than half of cases.
Viruses can cause pericarditis in humans and be transmitted through direct contact with an infected organ. For example, in one study of 670,000 healthy male military recruits, 17 patients were positive for viral genomes in their myocardium. Of these, twelve were found to have parvovirus B19 infection, and three were positive for enterovirus or adenovirus infection. Most cases had a favorable prognosis, but some patients developed persistent or recurrent infections. In these patients, colchicine or non-steroidal anti-inflammatory drugs may be recommended.
Symptoms of pericarditis are typically similar to those of acute inflammatory bowel disease, but an electrocardiogram helps diagnose. In acute pericarditis, the ECG is characterized by diffuse ST-segment elevation (DSE), but it is essential to remember that similar features can be found in patients with other conditions.
Another complication of pericarditis is an injury to the chest. Moreover, certain drugs, such as penicillin, can trigger pericarditis. Finally, despite rough the influenza B virus being rare, infection with this virus can lead to life-threatening pericarditis.
