Pericarditis

What is Pericarditis?
The hearts sits in the centre of the  chest and is surrounded by a sac called the pericardium. This sac has two layers, one that fits tightly onto the heart muscle and another looser layer surrounding the inner layer. Inflammation of these tissue layers surrounding the heart is referred to as pericarditis.

…..At A Glance
Pericarditis is an inflammation of the lining surrounding the heart (the pericardial sac).
Pericardial effusion is a collection of fluid in the pericardial sac. This fluid may be produced by inflammation.
The cause of pericarditis in most patients is unknown, although many diseases can cause pericarditis.
The diagnosis of pericarditis is made by history and physical examination including the presence of a rubbing sound heard (friction rub) with a stethoscope. It may confirmed by EKG and echocardiogram, an ultrasound examination of the heart
Pericarditis is treated with anti-inflammatory medications and by treating any underlying disease.
Pericardial tamponade occurs when enough fluid accumulates in the sac to compromise the heart’s ability to adequately pump blood.
Tamponade is treated by pericardiocentesis, removing the fluid with a needle. Sometimes surgery is needed to strip away part or the entire pericardial sac from the heart.

What Causes Pericarditis?
There are many causes of pericarditis. Most often the cause is unknown. Causes of pericarditis are listed below:
Idiopathic
The cause of the illness is not identified (although often it’s the result of a minor viral illness or “cold”)
Mechanical injury to the heart

What are the symptoms of pericarditis?
Chest pain is the most common symptom of pericarditis.
The pain is usually sharp and stabbing.
It can arise slowly or suddenly and can radiate directly to the back, to the neck or to the arm. If there is associated irritation of the diaphragm (the flat muscle that separates the chest from the abdomen), the pain can radiate to the shoulder blade.
The pain can be made worse with deep breaths (pleuritic).
The pain is frequently positional and made worse when lying flat and better when leaning forward.
These pain characteristics may help the doctor distinguish between pain from pericardial inflammation around the heart and angina (the pain from heart muscle that doesn’t get enough blood supply because of narrowed blood vessels).
The heart sits is the mediastinum, a space that exists in the middle of the chest between the lungs. The trachea, the breathing tube from the mouth to the lungs and the oesophagus, the swallowing tube from the mouth to the stomach are also located in the mediastinum. Some symptoms may depend upon where the inflammation may be in the heart lining.
There may be pain with deep breaths and shortness of breath because of that pain, if there is inflammation in the pericardium near lung tissue.
Pain may occur with swallowing if the inflammation is near the esophagus.
Other symptoms depend upon the specific cause of the pericarditis. For example, infections may present with fever, chills and other non-specific symptoms such as muscle aches and general malaise.