How often do we hear that someone has a heart condition, but rarely understand what is being said. There are many diseases associated with the cardiovascular system. And they all abound in obscure definitions and terms. Here, for example, the pericardium. What is it, where is it located and what does it suffer from?
What is a pericardium?
First of all, you need to understand what is at stake. The pericardium is a pericardial bag in which not only the heart, but also the pericardial vessels are placed. The word came to medicine from the Greek language. Its literal meaning is “around the heart”. Some doctors call the pericardium a pericardial shirt. In fact, this is the outer membrane of the heart from connective tissue.
By its structure, the pericardium is a closed bag resembling a truncated cone. In an adult, its narrow base lies on the diaphragm, the wide apex rests on the ascending aorta. The entire bag consists of two sheets, one of which is parietal, it is called the pericardium. The second is visceral, that is, the epicardium.
The structure of the pericardium is composite. There are two layers here: serous inner and fibrous outer. The fibrous layer consists of a dense fibrous tissue covering the heart and passing into the pulmonary trunk and the mouth of the pulmonary veins. The serous layer consists of dense connective tissue covered with squamous epithelium. In the serous tissue, a specific fluid is produced that fills the gap between the leaves of the pericardium and epicardium. It is a natural lubricant that facilitates friction. A healthy adult pericardial bag contains approximately 25 ml of fluid. Thus, the structure of the pericardium is due to the maintenance of tissue pressure and the implementation of a supporting function that prevents excessive stretching of the heart. Lubricating leaflets reduce friction when contracting an organ.
Pericarditis. Definition
Violation of the structure or functioning of the pericardium is called pericarditis. This is an inflammatory process that occurs in the tissues of the pericardial sac. Since the pericardium is an important component of a healthy cardiovascular system, any pathological processes are dangerous to humans.
Due to inflammation inside the cavity, fluid exudate accumulates. This leads to compression of the heart, which complicates the normal pumping of blood. The structure of exudate is of two types. It can be purulent or serous, depending on the nature of the pericardial lesion.
The main problem of patients is that the disease is difficult to diagnose. With heart diseases, doctors establish this diagnosis in only 0.5% of cases. However, according to statistics, up to 5% of cores die from pericarditis. In more than 80% of cases, the diagnosis is made after the autopsy.
Medical classification
Pericarditis is divided into three main groups. Pericardial diseases can be infectious, be aseptic or idiopathic.
The cause of infectious pericarditis can be tuberculosis, gonorrhea, syphilis, dysentery. Less common bacterial lesions such as cholera, typhoid and anthrax are also considered.
Manifestations of aseptic pericarditis are characteristic of rheumatic diseases, myocardial infarction, and aortic aneurysm. Also the cause may be injuries and surgery. Oddly enough, this sounds, but a similar pathology can be caused by extracardiac diseases, such as pneumonia, esophageal perforation, and others. Aseptic diseases of the pericardium can accompany blood cancer and malignant tumors in other organs. Sometimes the impetus becomes an allergy, medication or radiation therapy.
Idiopathic pericarditis has an unclear origin. The cause of the problem cannot be determined.
The development of pericarditis (infectious form)
The easiest way to identify pericarditis, which developed against the background of an infectious disease. In this case, to fight bacteria, immune processes in the body are triggered. The impact of pathogens on tissues and organs increases the permeability of vascular membranes. A fluid saturated with coagulation components penetrates the pericardium. This changes the composition of the lubricating fluid in the cavity of the bag, violates the structure of the pericardial tissue, turning it into scar. The first stage of the disease is dry pericarditis. The second stage is adhesive, in which adhesions and scars appear.
Symptoms of the first stage
When going to the doctor, patients with dry pericarditis complain of heart pain. Pain sensations have their own characteristics:
- From the moment of occurrence, within a few hours, the pain increases. The nature and intensity of pain from a weak approaching intolerable. It can be described as stitching, burning or crushing.
- Pain occurs behind the sternum, in the left armpit, in the epigastrium. They give to the neck or right hypochondrium and stomach.
- The pain increases with deep breathing, trying to swallow saliva or food, coughing, moving.
- The pain decreases if you lean forward or lie on your right side and tighten your bent legs.
It is indicative that the pain does not respond to the intake of Nitroglycerin, but decreases from pain medications.
Exudative form
As pericardial disease develops, fluid or pus begins to accumulate inside the pericardial sac. At this stage, chills, shortness of breath, dry cough, chest tightness, hiccups, cyanosis and swelling appear.
Treatment
Depending on the form and course of the disease, patients are prescribed analgesics, anti-inflammatory drugs and supporting agents. Magnesium and potassium preparations are also shown.
With purulent processes, antibiotics of a different method of administration are added. This can be an oral administration, intravenous administration or a catheter in the pericardial region. Purulent exudate requires removal.
In some cases, a pericardial puncture is prescribed. With adhesions, heart surgery is necessary.