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August 29th, 2008 at 11:33pm
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Pericardial effusion is defined as an abnormal collection of fluid in the pericardial cavity i.e. around the heart. As there is not that much amount of space in the pericardial cavity, the fluid accumulation leads to an increase in intra-pericardial pressure and this affects the cardiac function.
Whenever there is an accumulation of the pericardial fluid which is having enough pressure affecting cardiac function, then this is called as cardiac tamponade. Usually pericardial effusion is caused due to disturbance in the equilibrium between the production and re-absorption of fluid present in pericardium, or due to presence of any structural abnormality allowing the fluid to enter into the pericardial cavity. The pericardial fluid levels normally from fifteen to fifty milliliters.
It may be of transudative type such as congestive cardiac failure, myxedema, and nephrotic syndrome, or of exudative type such as tuberculosis, spreading from empyema or of hemorrhagic type like trauma, or rupture of aneuryms, and malignant effusion.
Causes of pericardial effusion
The causes of the pericardial effusion are pericarditis, or other infections, may be viral infection where the virus named coxsackie is causative, many times pericardial effusion is followed after the inflammatory disorders like lupus and post-myocardial infarction pericarditis which is commonly known as Dressler’s syndrome. Cancer may be also one factor which has spread to the pericardium. Other causes are cardiac surgery, Trichinosis and renal failure with hematuria.
Symptoms of pericardial effusion
A small type of pericardial may not have any symptoms rather than the chest pain and other pressure symptoms. Many times pericardial effusion is also seen after the repair of specific type of cardiac defect like an atrial septal defect secundum, or ASD. When these are repaired then there is more chance of development of a pericardial effusion, this happens due to one of the procedure of repairing. One type of repairing procedure is of ASD in which a piece of the peridcardial tissue is taken and is used for attaching as a patch for the hole in the atrial cavity.
The radiographic sign of pericardial effusion is called as water-bottle heart, in this sign, there is enlargement of the cardio pericardial silhouette and it assumes like the shape of a flask or of water bottle. So it is called as water-bottle heart. It is also seen associated along with Ewart’s sign.
Treatment of pericardial effusion
Treatment of pericardial effusion depends on its underlying cause and how severely the heart is impaired. Usually pericardial effusion caused due to a viral infection reveals within a few weeks that too without any treatment. And many of the pericardial effusions remains small and they never need treatment. But if the cause of pericardial effusion is a condition such as lupus then treatment is needed here containing anti-inflammatory drugs.
If the effusion is disturbing the function of the heart and is causing the cardiac tamponade then it needs the draining of fluid by inserting the needle through the chest wall into the pericardial space. Sometimes a drainage tube is left there itself for several days. Surgical drainage may be often required by pericardiocentesis, in this procedure, a needle or a catheter is used to drain excess fluid.
By admin
August 29th, 2008 at 11:32pm
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Constrictive pericarditis is defined as a chronic inflammation of the pericardial sac i.e. a sac like lining of the heart called as the pericardium making it thickened, scarring, and with the tightening of the muscle. Relatively this condition is rarely seen in children.
Commonly constructive pericarditis is caused due to another condition which is responsible for development of inflammation around the heart, such as cardiac surgery, Tuberculosis and Radiation therapy to the chest.
The conditions that less commonly causes the constructive pericarditis are:
Accumulation of abnormal amount of fluid within the lining of the heart may be due to the pericarditis caused because of bacterial infection or surgical complications. Mesothelioma is also considered as a cause for it. Many times it is also found that there is no any apparent cause for the development of the constrictive pericarditis.
The inflammation makes the lining of the heart more thickened and very rigid that produces difficulty for the heart to expand enough whenever it beats. And due to this, the chambers of the heart do not fill properly with enough amount blood. Thus it causes the swelling of the heart and also the other symptoms of heart failure.
Common features of constrictive pericarditis
There are various symptoms of chronic constrictive pericarditis. Patient may feel dyspnea i.e. difficulty in breathing, this symptom develops slowly and then gets worse. Many times patient feel fatigue and excessive tiredness, edema i.e. swelling on legs and on ankle joint for long time, even the abdomen is seen swollen. Weakness is also quite common.
Diagnosing and treating constrictive pericarditis
It is very difficult to make out the diagnosis of Constrictive pericarditis. It may be misdiagnosed with restrictive cardiomyopathy and cardiac tamponade because of the similar signs and symptoms. The physician may need to look for these conditions while making a diagnosis. After the physical check-up of the patient, it may show that veins of the neck stick out; this suggests raised blood pressure in that area. This condition is called as Kussmaul’s sign. While listening to the chest with the help of stethoscope, the physician notices the weak or distant type of heart sounds. While going through physical exam it may also find that there is swelling of the liver and accumulation of fluid in the abdominal region.
Along with the physical exam some more tests are to be done, those are MRI-chest, CT scan chest, ECG, X-ray chest and either cardiac catheterization or coronary angiography.
To improve the cardiac function is the main aim of the treatment. First the cause must be identified and then must be treated. For this, treatment may need certain antibiotics, drugs those are tuberculosis or other types of treatments. Such as, diuretics are used in small doses in order to remove the excess fluid from the body.
To get rid of the pain analgesics are prescribed. Some of the patients must be told to decrease their activity. Even low-sodium diet recommended. The exact treatment is a surgery called pericardiectomy. In this surgery there is removing or cutting the scarring and the affected part of the pericardium.
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August 29th, 2008 at 11:31pm
Under Casues+ Chronic Perocarditits+ Details+ New+ overview
Pericarditis can be defined as inflammation of the thin and protective membrane that lines the heart from outside. The inflammation here means redness and swelling of the membrane. The membrane surrounds the heart and keeps it in its proper anatomical location. The heart is most delicate organ in the human body and any pressure on it makes it uncomfortable and painful. The membrane is closest to the heart and thus inflammation of the membrane makes heart to pain which is the first symptom of pericarditis.
In case of acute pericarditis, commonest symptom is sharp and stabbing chest pain that is felt just underneath the breastbone or slightly left side of the chest. Nevertheless, some of the people suffering from acute pericarditis report their chest pains as dull and achy or feeling like someone has put lots of pressure on their chests. The intensity varies and they describe that the pain may travel to their neck, left shoulder and then coming down to the left arm finally ending in left palm (called as radiating pain in medical science).
The chest pain is most discomfort among all the symptoms pericarditis features. The heart becomes heavy and there is a feeling of something that is crushing the heart. The pain generally steps up when the patient lies down or takes deep breath. Oppositely, it eases up when the patient sits up and leans forward. At times, it becomes difficult to differentiate between the pericardial chest pain and the pain that occurs during heart attack.
Apart from chest pain, there is some other symptoms pericarditis as mentioned below:-
§ Mild fever or feverish
§ Shortness of breath (medically known as dyspnea)
§ Coughing (generally with phlegm)
§ Hiccups (medically known as eructation)
§ Muscle-ache or severe body pain especially left part of the body.
§ Uneasiness
§ Congestion in the thorax/chest region
§ Giddiness (in some cases)
In some of the cases, people suffer from nausea, profuse sweating/perspiration that are associated with chest pain. There might be indigestion that ends up with constipation but not necessary in all the cases of pericarditis. Whatever the symptoms pericarditis has, it makes patient tired, very weak and exhausted. The condition certainly interrupts routine activities and level of consciousness.
The type of chest pain felt during the pericarditis is also different from the angina. The angina generally turns worse with exertion but remains unaffected with deep breathing. In case, the pericarditis is left untreated, it can develop its complications. The complication is fatal and the patient is at risk of sudden cardiac failure.
The symptoms of complication of pericarditis include severe breathlessness or shortness of breath (dyspnea) and irregular or rapid heartbeats all of a sudden. The coughing is severe and unbearable up to an extent that it becomes difficult for the patient to speak and to breathe. The cough might bring up foamy pink or yellow mucus. The sudden heart failure requires immediate medical attention that requires intensive cardiac care unit admission and proper treatment.
By admin
August 29th, 2008 at 11:27pm
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Peri-card-it is; according to Greek language, peri means around, pericardium means around the heart and itis means inflammation. Pericardium is a specialized tissue sac around the heart thus pericarditis means the inflammation of the pericardium. Pericarditis is further distinguished on the type of the liquid oozing out of the inflammation such as of serous type, maybe of purulent in nature, may contain fibrin, and maybe of hemorrhagic type.
The case of acute pericarditis is common than the case of chronic pericarditis, and it can come in front as a complicated type of infections or a heart attack. The commonest sign of pericarditis is chest pain which radiates towards the back and is ameliorated by sitting in up-forward position and is aggravated in the lying down position. There are many other signs of pericarditis such as; anxiety, fever, fatigue and dry cough. Many times pericarditis is misdiagnosed by the physician as the myocardial infarction, in common words it is known as heart attack.
There are various causes of pericarditis. Oftentimes the cause is unknown. Following are the causes of the pericarditis:
- Idiopathic: The cause behind the illness is not known.
- Viral infection: Many times it is developed followed by a minor viral type of illness mostly by the Coxsackie virus.
- Bacterial infection: Commonly caused by Tuberculosis bacillus. Pericarditis where the tuberculosis is the causative factor, then this condition is quite difficult to diagnose. However, to confirm it, the culturing Mycobacterium tuberculosis from aspirated fluid from the pericardium or pericardial biopsy is required. One system called as ‘Tygerberg scoring system’ is helpful for the physicians to find out whether the cause of pericarditis is tuberculosis or any other.
- Fungal infection.
- Different types of immunologic conditions such as Lupus erythematosus, this is commonly found in females.
- Dressler’s syndrome that is followed by the Myocardial Infarction.
- Any type of trauma to the heart, maybe like any inflammation or infection followed by puncture.
- Uremia: The urea i.e. the nitrogenous waste products that are normally excreted in the urine get accumulated in the blood.
- Some Malignancy
- As a side effect of some drugs such as cyclosporine, isoniazid and hydralazine.
- Maybe the result of the induced Radiation.
- Aortic dissection may be also one of the causes.
- Tetracyclines are also found to be a causative factor for pericarditis.
Most of the cases of acute type of idiopathic pericarditis get resolved without any type of complications. Complications may be like pericardial effusion, constrictive pericarditis and cardiac tamponade.
Fibrinous pericarditis is one of the exudative types of inflammation. Here the pericardium is penetrated by the fibrinous exudate. This is containing the chains of fibrin as well as the leukocytes.
The treatment in the viral pericarditis or the idiopathic pericarditis is obtained with non-steroidal anti-inflammatory drugs, but many other severe types of cases may need the treatments like antibiotics, pericardiocentesis, colchicine, steroids and oftentimes a surgery is preferred as effective way to cure the disease.
By admin
August 9th, 2008 at 04:31pm
Under Details+ New
Pericarditis most often sways men elderly 20-50. Pericarditis may be acute or chronic. Heart strike (see post-MI pericarditis) and myocarditis can origin pericarditis, as can emission treatment to the barrel and medications that stifle the immune system. Acute pericarditis due to tuberculosis starts insidiously, occasionally without conspicuous symptoms of lung infection. It may make high warmth and symptoms of heart malfunction, for example flaw, fatigue, and adversity breathing. Cardiac tamponade may occur. Pericarditis can be misdiagnosed as myocardial infarction, and vice versa. Pericarditis is more widespread in adolescents and juvenile adults. In a latest study, Merce et al discovered no distinction in etiology, clinical course, and prognosis between aged and junior patients with moderate and large pericardial effusions.
Pericarditis happens in up to 15% of patients who have acute myocardial infarctions (heart attacks). There is furthermore a late pattern of post-heart-attack pericarditis, called Dressler’s syndrome, that happens weeks to months after the heart attack. Chronic pericarditis happens when the pericardial inflammation does not determination inside a couple of weeks. Constrictive pericarditis happens when a chronically increased pericardial sac twigs to the heart sinew, compressing it constricting it. A CT or MRI scan can furthermore help to identify chronic or constrictive pericarditis, by displaying the condensing of the pericardial coating affiliated with these conditions. Potential causes of cardiac perforation encompass centered line placement, pacemaker insertion, cardiac catheterization, sternal skeletal part marrow biopsies, and pericardiocentesis.
Pericarditis generally happens in flare-ups, but it may be the giving manifestation. Constrictive pericarditis is a very tough therapeutic problem. Diuretics may be utilised to eliminate surplus fluid built up in the pericardial sac. Bacterial pericarditis should be treated with antibiotics. Fungal pericarditis is treated with antifungal agents. Medicines, for example aspirin, ibuprofen, or other nonsteroidal anti-inflammatory pharmaceuticals (NSAIDs), are routinely utilised to organise the agony and inflammation. Acute inflammatory pericarditis generally lasts one to three weeks and doesn’t lead to farther problems. About 20 per hundred of pericarditis patients have a recurrence inside months or, seldom, inside years. Pericarditis is treated with bed rest, diuretics, and digitalis, but definitive remedy needs surgery to narrow piece the condensed pericardial coating from the heart.
By admin
August 9th, 2008 at 04:19pm
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It determinants distinct barrel agony, but it’s not a heart attack. Pericarditis is an inflammation of the coating round the heart called the pericardium, as asserted by the March topic of Mayo Clinic Health Letter.
Acute pericarditis normally makes pointed, stabbing barrel agony underneath the breastbone or on the left edge of the chest. For some, the barrel agony may be a boring throbbing or force, and it may alter in intensity.
It can happen abruptly or gradually over time without a clear cause. It can evolve after a heart strike or with situation for example a viral contamination, connective tissue infection or kidney failure. Whatever the origin, pericarditis generally can be unblocked up with anti-inflammatory medications.
There’s no inquiry that barrel agony, even if it’s supposed pericarditis, warrants direct health care. The symptoms imitate those of a heart strike or a body-fluid clot in the lung, both crisis conditions. Diagnostic checks, encompassing an electrocardiogram to assess the heart’s impulses, will show if the origin is pericarditis or certain thing else.
It normally takes one to three weeks to retrieve from acute pericarditis. The huge most of persons who have an episode of pericarditis retrieve completely if they’re identified and treated promptly.
By admin
August 9th, 2008 at 04:05pm
Under New
It determinants distinct barrel agony, but it’s not a heart attack. Pericarditis is an inflammation of the coating round the heart called the pericardium, as asserted by the March topic of Mayo Clinic Health Letter.
Acute pericarditis normally makes pointed, stabbing barrel agony underneath the breastbone or on the left edge of the chest. For some, the barrel agony may be a boring throbbing or force, and it may alter in intensity.
It can happen abruptly or gradually over time without a clear cause. It can evolve after a heart strike or with situation for example a viral contamination, connective tissue infection or kidney failure. Whatever the origin, pericarditis generally can be unblocked up with anti-inflammatory medications.
There’s no inquiry that barrel agony, even if it’s supposed pericarditis, warrants direct health care. The symptoms imitate those of a heart strike or a body-fluid clot in the lung, both crisis conditions. Diagnostic checks, encompassing an electrocardiogram to assess the heart’s impulses, will show if the origin is pericarditis or certain thing else.
It normally takes one to three weeks to retrieve from acute pericarditis. The huge most of persons who have an episode of pericarditis retrieve completely if they’re identified and treated promptly.
By admin
August 9th, 2008 at 04:00pm
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Symptoms Pericarditis is the enlarging of the tissue surrounding the heart, called the pericardium. In some situations, a heart strike, surgery on the heart, certain medications or diseases can origin pericarditis. Pericarditis can furthermore present in persons who are absolutely wholesome but may have lately had a secondary virus. When no direct origin can be discovered, medical practitioners mark this last cited pattern as idiopathic pericarditis.
Pericarditis is distinuished by farthest agony in the chest. Usually the agony is sensed underneath the sternum or breastbone. Pain worsens with breathing. This agony should not be brushed aside as pericarditis, which usually resolves on its own, but needs direct health attention. Similar agony is sensed upon experiencing a heart strike or other grave situation, and desires to be considered immediately.
Chest agony from pericarditis may boost or decline when one alterations positions. Lying down may be especially uncomfortable. Even a transition from seated to standing can origin the agony of pericarditis to either advance or get worse.
People experiencing pericarditis may furthermore observe sore sentiments in their neck and/or back. Pain in the stomach escorted by agony in the barrel can be exceptionally unsafe, and does not generally show pericarditis. Instead, this can signify rupture of part of the intestinal tract, a life-threatening emergency.
Pericarditis may furthermore be escorted by pericardial effusions, an accumulation of fluid between the pericardium and the heart. A minor high warmth, and a feeling of strong irritability generally escort pericardial effusions. Certain situation, like latest surgery on the heart may make one more disposed to pericardial effusions. The status can furthermore originate from contamination of the heart.
In some situations, capacity of fluid accumulation can location force on the heart and constraint its movement. Usually, those influenced may have to take diuretics to help the body flush the fluid, or in poorest situations, a tap of the pericardium is finished to eliminate the fluid by needle. Though this method noise scary, it is often presented and has a high rate of success.
In all situations, those supposing pericarditis should search direct health treatment. Diagnosis can affirm pericarditis, or issue to other very grave situation that can be life threatening.
By admin
August 3rd, 2008 at 11:41pm
Under Details+ New+ What
What is fungal pericarditis?
If you possess fungal pericarditis, you are presumably already severely sick with another infection such as lymphoma, leukemia or endocarditis. Fungal pericarditis is frequently a complication of a pulmonary (lung) disease or may be a complication of cardiac surgery. The symptoms are typically the equalled as those of the underlying disease. If deserted untreated, fungal pericarditis shall act towards pericardial constriction. The counseling involves medication for the underlying infection.
What is uremic pericarditis?
Uremic pericarditis is inflicted by mechanism of kidney failure and may be handled by mechanism of dialysis, which is a arrangement that filters and cleanses the blood. This arrangement may be necessary towards dampen the severity of your symptoms. In rare, but harsh cases, a pericardiectomy shall be performed. If you possess uremic pericarditis, your symptoms may embroil chest ache and a fever.
How is pericarditis diagnosed?
Your nurse shall steal your medical history and serve a finalise physical examination. He shall command diagnostic tests. These may embroil blood exams, chest x-rays, electrocardiograms (ECGs) and echocardiograms. He may command Computed Tomography (CT) and Magnetic Resonance imaging (MRI) scans towards determine whether there has been a thickening of the pericardium. He may command a diagnostic biopsy.
How is pericarditis treated?
Most civilians are handled for pericarditis outdoors the hospital setting. Treatment may include: ache predators, antibiotics, antituberculous officers, fungicidal drugs, dialysis, and chemotherapy, depending upon the theory and basis of the disease.
Sometimes pericarditis is handled within the hospital. If you lack towards be hospitalized, you shall be gave strict bed lie down until your symptoms abate. In the hospital, you shall elicit ache killers. You may be gave corticosteroids towards speed the healing. You may undergo a arrangement branded “pericardiocentesis” within which the liquid within your pericardium shall be emptied across a catheter which is spaced into your pericardial cavity. The drainage may steal a lot hours towards overnight. Finally, you may possess towards undergo surgery.
By admin
August 3rd, 2008 at 11:40pm
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If your pericarditis persists for six months towards twelve months serial the acute occurrence, it is interviewed chronic.
Constrictive pericarditis is a harsh model of pericarditis within which the pericardium becomes so thickened and scarred that it sacrifices a figure of of its elasticity. It tightens the heart, interferes with the ability of the heart towards fill upward with blood, and lessens the volume of blood pumped out towards the body. Constrictive pericarditis may inflict heart failure and instruction towards kidney disease.
If you possess constrictive pericarditis, you may experience chest ache, trouble within breathing, bulging of your feet and ankles, fatigue, and weakness.
You may be gave a low dose of diuretics (water pills) towards slowly loss excess fluid. You may be gave ache predators and placed onto a low sodium diet.
If you possess divisive symptoms which are not tempered by mechanism of otherwise methods, medicine may be recommended. The medicine involves a tall threat arrangement branded a “pericardiectomy” This arrangement entails the removal of a homework or everybody of the pericardium towards rid the constriction.
Constrictive pericarditis may be deadly whether untreated.
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