What is Pericardial Disease?
Pericardial disease are conditions that affect your pericardium. Your pericardium is a flexible, two-layered sac that surrounds your heart. Your pericardium contains your heart in your chest wall. It keeps your heart from over-expanding when your blood volume increases. It also provides lubrication and shields your heart from infection.
Pericardial Disease Types
There are several types of pericardial disease:
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Pericarditis
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Pericardial effusion
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Cardiac Tamponade
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Constrictive Pericarditis
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Dressler’s syndrome
Pericarditis
Pericarditis is inflammation of your pericardium. Pericarditis usually develops suddenly. The condition may last for a few weeks or up to several months. In some cases, pericarditis can cause pericardial effusion or fluid build-up in the sac. This build up can compress the heart. Pericarditis can also sometimes return, even after adequate treatment.
There are several types of pericarditis:
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Acute pericarditis begins suddenly but does not last longer than a few weeks.
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Chronic pericarditis is inflammation that lasts three months or longer.
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Recurrent pericarditis is inflammation of the heart sac that is adequately treated, but returns again in a separate episode.
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Constrictive pericarditis can develop after multiple episodes of pericarditis. The inflamed layers of your pericardium stiffen and develop scar tissue. The thickened layers interfere with your heart’s regular function.
Myocarditis vs Pericarditis
Both myocarditis and pericarditis are types of inflammation in your heart. The difference is where in your heart they occur. Myocarditis happens in your heart muscle. Pericarditis happens in the lining around your heart.
Pericarditis Causes
In most cases, the exact cause of pericarditis is not known. Infections, injuries, and some autoimmune diseases may cause pericarditis.
Pericarditis Symptoms
Chest pain is the most common symptom of pericarditis. It may feel sharp or stabbing. You may also experience a dull ache or pressure. Your chest pain may get worse when you cough, swallow, breathe deeply, or lie flat.
There are other symptoms of pericarditis:
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Fatigue or overall weakness
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Swelling in your legs or feet
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Coughing
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Fever
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Pain in your back, neck, or left shoulder
Chest pain should always be taken seriously. Call 911 if you experience concerning symptoms.
Find a Pericardial Disease Specialist
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Pericarditis Diagnosis
A health care provider diagnoses pericarditis. Your provider will review your medical history and ask questions about your symptoms. They will listen to your heart with a stethoscope. Pericarditis causes a very specific sound, called a pericardial rub. The sound happens when the two layers of your pericardium rub together. This sound is not always present, and additional testing is usually needed.
Pericarditis Tests
Your provider may recommend tests to diagnose pericarditis or to rule out other conditions:
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Blood tests
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Electrocardiogram (ECG)
Pericarditis Treatment
Treatment options for pericarditis depend on your individual needs and symptoms. Mild pericarditis may get better without treatment. Medication is the most common treatment options for pericarditis. If you have fluid buildup in your pericardium, you may need to have the fluid drained. In severe cases of constrictive pericarditis, you may need surgery. Your provider will review your options with you. Together, we’ll create a treatment plan that’s right for you.
Pericardial Effusion
Pericardial effusion is a buildup of fluid in the space around your heart. Your pericardium contains a small layer of fluid. If your pericardium is injured, inflamed, or diseased, too much fluid can build up and cause problems.
If the fluid buildup is severe or happens quickly, it can put pressure on your heart. This is a life-threatening medical emergency called a cardiac tamponade.
Cardiac Tamponade vs Pericardial Effusion
Cardiac tamponade (also called pericardial tamponade) is a medical emergency. The term refers to a heart that has so much fluid compressing it that it cannot function properly.
A pericardial effusion doesn’t always cause cardiac tamponade. In most cases of pericardial effusion, the fluid builds slowly over time. This allows your pericardium to stretch and make more room. Cardiac tamponade happens when pressure from the quickly growing fluid keeps your heart from beating properly. The rapid addition of fluid doesn’t allow room for your heart’s chambers to expand and fill. When this happens, your heart pumps less blood, leaving your organs without blood flow.
Pericardial Effusion Symptoms
A mild case of pericardial effusion may not cause symptoms. Symptoms are more noticeable when an effusion happens quickly. Cardiac tamponade and pericardial effusions share many symptoms:
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Chest pain or pressure, usually on the left side of the chest
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Feeling lightheaded, dizzy, or faint
Pericadial Effusion Diagnosis
A pericardial effusion is diagnosed using similar methods used to diagnose pericarditis. Your health care provider discusses your health history, asks questions, and listens to your heart with a stethoscope. They may order imaging tests:
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EKG
Pericardial Effusion Treatment
Treatment for pericardial effusion depends on several factors:
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The amount of fluid buildup
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The cause of the effusion
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The presence or risk of cardiac tamponade
If your effusion is small and not bothering you, you may not need treatment. Your provider may suggest waiting and watching your effusion to see if it changes size or causes symptoms.
If you are not at risk of cardiac tamponade, your provider might prescribe medication to treat the inflammation in your pericardium.
Your provider may recommend a procedure to drain the fluid if you meet certain criteria:
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The medications don’t ease your pericardial effusion.
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The effusion is large, causes troubling symptoms, or increases your risk of cardiac tamponade.
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You have cardiac tamponade.
There are different options to remove pericardial fluid from your pericardium:
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Needle aspiration and drain—Your provider numbs a small area on your chest. They use imaging of your heart to help guide them. They insert a needle into your pericardium. A tube is often left in to allow for continued relief and to prevent the fluid from rapidly returning.
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Surgery—Your provider may recommend surgery. Surgery to relieve pericardial effusion can be a long term treatment as in the case of recurrent pericardial tamponade.
Pericardial Disease Prevention
There is no set way to prevent pericardial disease. It is important to receive an accurate diagnosis if you have pericarditis. You should seek and complete treatment to reduce the chance of your pericardial disease returning or life-threatening consequences. To avoid pericarditis caused by infections, practice good hygiene. Reduce your risk of heart problems by not smoking. Get regular exercise, eat a healthy diet, and manage your blood pressure.
Make an Appointment
You'll need a referral to visit with our pericardial specialists. Ask your health care specialist to submit a referral for you. They can call us at 801-585-7676 or fax in your information at 801-587-729. They can also submit a referral online.
Why U of U Health?
U of U Health has year-after-year exceptional rankings as offering the best health care in the nation. It's not a surprise. We believe collaboration throughout our system — from physicians, researchers, biologists, and more — leads to the most imaginative care.
U of U Health Cardiovascular Medicine is currently one of the American Heart Association designated centers at improving recurrent pericarditis care. We actively participate in clinical research and trials.
Working together in a rich clinical environment means our discoveries have a direct impact on the health of our patients. U of U Health isn't satisfied with just providing health care. We continue to transform it.
