There are various diseases that can have a strong negative effect on the work of the main organ of the circulatory system - the heart. This article will focus on one of the common problems that has the name pericarditis. This disease is dangerous and deserves to be given attention.
What disease are we talking about
If you try to determine in scientific language what pericarditis of the heart is, the symptoms of which concern many people, then we can say the following: it is an aseptic or infectious inflammation of the parietal and visceral pericardial leaves. But in simple terms, we are talking about a chronic or acute form of inflammation of the outer lining of the heart (pericardium), the cause of which is rheumatic fever, the effect of infection or other types of effects.
In order to understand the essence of this disease, it makes sense to pay attention to general information.
The pericardium is a pericardial bag in which such an important organ as the heart is located. Moreover, the very fact of active reduction in such a bag is possible due to its special structure, which prevents the appearance of strong friction.
Symptoms of pericarditis in adults make themselves felt, provided that the functioning and structure of the lining of the heart are impaired. In this case, accumulation in the pericardium of effusion (secretion), having a serous or purulent character, is possible. Such a liquid is defined as exudate. It is under its influence that the heart is compressed, because of which the performance of its direct functions is disrupted. Obviously, this condition is dangerous and cannot be ignored.
If there is an excessive accumulation of fluid in the pericardium, then there will be a direct threat to human life. In this condition, death can be avoided only with immediate intervention.
It is worth noting that such a disease manifests itself most often in women, less often in men. As for children, at a very young age this diagnosis is extremely rare, although this sometimes happens.
Causes of occurrence
Before considering the symptoms of pericarditis in humans, it is worthwhile to find out what precedes the emergence of such a difficult disease.
You need to understand the following fact - the accumulation of fluid can be a consequence of various processes in the body:
- complication of the pathology of internal organs;
- a sign of diseases of the heart itself;
- the result of the injury;
- the manifestation of infectious diseases of a general nature;
- A sign of systemic diseases.
But if we talk about the most common causes, then first of all, attention should be paid to the effects of infection. In this case, the symptoms of pericarditis can be a manifestation of its various forms:
- infectious and allergic;
- infectious;
- non-infectious (non-purulent, aseptic).
In fact, we are talking about problems with the state of the pericardial sac in the following diseases:
- viral infections such as influenza and measles;
- parasitic infestations;
- tuberculosis, provided that the infection spreads from an extrapulmonary tuberculosis or primary pulmonary focus;
- microbial diseases (septic processes, scarlet fever, tonsillitis);
- fungal infections.
In addition to the effects of these diseases, the symptoms of pericarditis can result from serum sickness or drug allergies.
A separate group of problems of the pericardial sac should include those forms of pericarditis that develop under the influence of emerging pericardial malformations with the formation of diverticula and cysts.
Types of disease
No matter how the symptoms of pericarditis look, they will always indicate the development of one of two key types of this disease: acute or chronic.
If we talk about the chronic form, then you need to pay attention to the fact that it develops gradually and may not make itself felt for several years. Moreover, such pericarditis has several common forms:
- adhesive, or adhesive, during which scars and rations are formed;
- the mixed appearance of adhesions, fluids and scars;
- effusion, or exudative form, characterized by a large accumulation of fluid in the pericardial sac.
Acute pericarditis, whose symptoms appear much faster, also has several key forms:
- effusion, with the formation of a significant amount of fluid (pus, bloody contents or blood plasma);
- fibrinous, or dry, characterized by a large accumulation in the pericardial cavity of adhesive substance from blood plasma (fibrin).
Constrictive and exudative pericarditis: symptoms
In order to respond to the disease in time and begin timely treatment, you need to know at least the general signs of the problem. And if we talk about the exudative form of the disease of the pericardial sac, then you need to pay attention to this: with such a problem, the fact of fluid accumulation is often found during fluorographic examination, as well as when using echocardiography.
If a tumor of the chest or lung has been fixed, it also makes sense to suspect the development of pericarditis. A similar diagnosis can be made in patients with uremia, during which cardiomegaly develops for no apparent reason, and an increase in venous pressure is also observed.
The situation is somewhat different with such a problem as constrictive pericarditis, the symptoms of which at an early stage are often practically not noticeable. The tangible signs of the disease make themselves felt when enough fluid accumulates in the pericardial sac in order to complicate the work of the heart. Obvious signs appear over time after physical exertion in the form of severe shortness of breath and increased fatigue. In people with such a problem, the fact of sudden weight loss and a marked decrease in appetite can be recorded.
There are other signs indicating constrictive pericarditis of the heart. Symptoms over time may increasingly resemble the consequences of right ventricular heart failure. We are talking about ascites, peripheral edema, pain and severity in the right hypochondrium.
How does dry pericarditis manifest
Speaking about this form of diseases of the pericardial sac, you need to pay attention to the fact that this problem is often preceded by myalgia or fever. But this is not limited to the difficulties caused by dry pericarditis. Symptoms eventually manifest as pain, which is localized in the chest area.
Such symptoms can persist for several days and even weeks, clearly expressing itself with the sternum. Possible pain in both hands or one upper limb, as well as in the trapezius muscles. The pain becomes especially acute when trying to change the position of the body. When coughing, swallowing, and breathing, discomfort can also be felt.
In the case of the development of a problem such as dry pericarditis, the symptoms worsen a little if a person occupies a sitting position. But if the patient lies on his back, the effect will be the opposite - health will worsen.
In some cases, pain can be disturbing around the clock. In this case, radiation will be observed in one or both hands. A similar condition can stimulate myocardial infarction.
In this case, the absence of the pain described above during a gradual development of the process of fluid accumulation is also possible. Most often, this condition is caused by the formation of a problem with the pericardium against the background of tuberculosis, uremia, tumor lesions, and after radiation exposure sessions.
But pain is not the only symptom that accompanies dry pericarditis. Dyspnea and signs of dysphagia are possible.
Acute pericarditis
With this form of the disease, the earliest and most obvious symptom is pain in the heart. At the same time, the place of occurrence and the strength of these unpleasant sensations can change.
Most often, pain is observed in the lower part of the sternum or in the apex of the heart. Irradiation to the neck, left shoulder blade and arm is possible.
When exacerbation of pericarditis is observed, the symptoms appear in the form of very severe pain. This condition may resemble myocardial infarction or pleurisy. In some cases, the pain is aching and dull. Sometimes patients begin to feel heaviness in the heart.
If during exacerbation there is pain in the heart, then most likely you have to deal with dry pericarditis.
With exacerbation, the appearance of shortness of breath is not ruled out, which will indicate the presence of effusion in the pericardial bag. At the same time, the more fluid has accumulated in the pericardium, the stronger will be breathing problems. In order to temporarily feel better you need to sit down. In this case, shortness of breath will significantly decrease due to the concentration of exudate in the lower part of the pericardial sac and, as a result, the pressure on the heart itself will decrease. Blood circulation improves as a result, and the patient feels relief.
Shortness of breath itself may be accompanied by coughing, and in some cases even vomiting.
How is pericarditis in children
As mentioned above, such problems with the work of the heart at an early age are rare. Nevertheless, the risk of developing such a disease before adulthood is possible.
So, what does pericarditis look like in children. Symptoms in such young patients, as in adults, are often signs of the development of another, underlying disease. Most often we are talking about the effects of various viruses. Much less often, the disease develops against a background of tuberculosis or rheumatoid arthritis. The cause of pain in the heart can also be the effect on the children's body of diseases of the connective tissue, for example, systemic lupus erythematosus.
Another reason why the pericardial sac is affected at an early age is severe staphylococcal and, less commonly, septic processes. Immunological genesis is characteristic of most childhood pericarditis. In the case of the development of so-called uremic pericarditis in severe renal failure, the disease can be toxic.
Problems with the pericardial sac in children with purulent processes are most often metastatic. This means that they develop due to either a breakthrough of the purulent focus in the pericardium from the myocardium, or due to hematogenous drift.
As for the general symptomatology, moderate cyanosis, shortness of breath, stitching pains in the region of the heart and fever can be attributed to it.
In the case of the development of dry pericarditis, the noise of pericardial friction will be heard above the heart. Often, the dry form should be exudative and you need to be prepared for this. In this state, the pain and friction noise disappear, but the dimensions of cardiac dullness expand and the state as a whole worsens.
Here's how children's pericarditis manifests itself. Symptoms and treatment in this case are solely the responsibility of the physician. Parents are better off not trying to influence the body of their beloved child on their own. A quick visit to the hospital would be the best solution.
Diagnostics
Of course, not all inhabitants are so sophisticated experts in medicine that they can independently determine the obvious signs of dry pericarditis without the help of a doctor. That is why it is important to remember that in the conditions of modern medicine there is always the opportunity to undergo a diagnosis with the participation of qualified doctors.
So, if you feel worse and have feelings that are even remotely reminiscent of the symptoms of pericarditis, you should immediately go to the doctor, who will be able to determine during the examination the presence of external signs of the underlying disease and fever including. With the help of palpation in the case of pericarditis, it is possible to identify the noise of friction of the pericardial sac over the area of cardiac dullness.
As a rule, they also listen to such noise in order to get a more accurate picture of the patient's condition. For this, a phonendoscope is used, which is strongly pressed against the chest. The patient at this time should be in an upright position, holding his breath while exhaling.
For a more accurate diagnosis, laboratory data can be used, as well as ECG readings.
Symptoms of pericarditis on the ECG, especially in its acute dry form, are expressed in the form of signs characteristic of subepicardial myocardial damage. If there is a significant accumulation of fluid, then the signs of the disease with this type of diagnosis will be expressed by reducing the voltage of the QRS complexes.
Treatment
With a disease such as pericarditis, symptoms and treatment require a competent assessment and approach. First of all, you need to provide bed rest. This rule is especially relevant in the case of diagnosing an exudative form of the disease. On average, such a regimen lasts about a month and can be expanded only if significant improvements in the patient's condition are noticeable.
If dry pericarditis was fixed, then there is no urgent need for a constant stay in bed.
But, returning to the exudative form, it should be noted that with its exacerbation, immediate hospitalization in the intensive care unit is necessary. The patient will have to see a thoracic surgeon. As for nutrition during a disease such as pericarditis, this issue is regulated taking into account the underlying disease.
If the cause of fluid accumulation in the pericardium is an infection, then antibiotic treatment may be prescribed. In the case of tuberculosis, appropriate drugs are also used, but such treatment will require significantly more time.
Often with problems with the pericardial bag, an effect is prescribed by means of anti-inflammatory drugs. To reduce the severity of pericarditis and neutralize the pain syndrome, non-steroidal drugs such as Voltaren, Indomethacin, etc. are relevant.
Glucocorticosteroids, in addition to the above effects, can have an immunosuppressive and anti-allergic effect. For this reason, they are defined as effective means of pathogenetic therapy.
Such drugs are indicated in the case of the diagnosis of the following types of pericarditis:
- with myocardial infarction, he is Dressler's syndrome;
- in the case of systemic diseases of the connective tissue;
- if there is an active rheumatic process;
- with persistent tuberculous pericarditis;
- exudative form with an unexplained cause and accompanied by a severe course.
In most cases, a drug such as Prednisone is prescribed. This course usually lasts several weeks with the gradual discontinuation of the use of this tool.
Attention should be paid to the puncture of the pericardium. It is a puncture of the cavity of the pericardial sac and evacuation of effusion, which creates pressure on the heart. This puncture is carried out urgently if there is a rapid accumulation of exudate, leading to the risk of cardiac tamponade.
Puncture can also be carried out with a purulent form of the disease; in this case, after removing the fluid, antibiotics and other topical medicines are introduced into the pericardium by means of a needle.
The rapid accumulation of exudate can also lead to the development of constrictive pericarditis. In this condition, it is necessary to limit the consumption of table salt to 2 g per day and significantly reduce the amount of fluid that the patient consumes. The prescription of diuretics will be relevant.
In especially severe cases, surgery can be performed. It is used mainly in the absence of the desired result after drug treatment during constrictive pericarditis. When the patient's condition improves, the surgeon performs a pericardectomy in order to free the left ventricle of the heart from constant compression.
Folk remedies
There are a number of alternative methods for treating a problem such as pericarditis. Symptoms and treatment with folk remedies for the manifestations of this disease is a hot topic. But it is worthwhile to understand that replacing the main medical process with folk methods is a big mistake. The accumulation of fluid in the pericardial sac is a problem, accompanied by rapid complications that cannot be neutralized without proper diagnosis and qualified treatment.
Folk remedies are permissible only in the recovery period, as an accompanying effect. But in any case, initiative is not welcome, it is better to take all actions after consultation with your doctor.
As for topical potions, decoctions of rose hips, strawberries, hawthorn and St. John's wort are acceptable.
For those who have pets, the topic will be relevant: "Pericarditis in dogs: symptoms and treatment." In principle, other animals may have problems with the pericardial sac. Symptoms with this problem are reduced to the appearance of fever, soreness in the heart, as well as general depression of the animal, which is sick. In general, the symptomatology is similar to the course of the disease in humans, so if the domestic animal is depressed, it is better to take him to the veterinarian, otherwise you may encounter serious complications.
Symptoms of pericarditis in animals can appear after injuries of various kinds. Therefore, if a beloved dog is injured, it is simply necessary to organize a check of his condition through time.
Summary
Pericarditis is a fairly serious disease, so you can not ignore it. For this reason, the townsfolk should be familiar with at least the general symptoms. This will allow you to recognize a dangerous illness in time and consult a doctor. With this approach, there is every chance of undergoing effective treatment, preventing possible complications. Do not forget that if the fact of fluid accumulation near the heart is not affected in any way, a fatal outcome can occur. So it’s better to find time for an additional visit to the doctor.