The heart is surrounded by a protective tenuous avascular sac bed as the pericardium , which take an insignificant amount of fluids . Any inflammation to the pericardium is squall as “ Pericarditis . ” Pericarditis syndrome may be acute , subacute , chronic or perennial form . ague form is the most frequent inflammatory syndrome come across in clinical practice , usually go not more than 6 week . Chronic form is the long - hold out inflammatory syndrome ( > 6 months ) which is characterized by more accumulation of fluid and thickening of the pericardiac pouch . It is uncommon , in general predate by acute pericarditis sort . Patient showshortness of breathaccompanied with a coughing , tiredness , sharpchest pain , and pain in the neck perhaps will occur in the shoulders , neck opening , or hands . coughing and abnormal breath go on due to the high pressure sensation in the blood vas of the lungs and tiredness take place because the pericardium restricts the normal heart ’s pumping activeness .
What Can Cause Chronic Pericarditis?
Chronic Pericarditis may be stimulate by many cistron . Several cases are idiopathic i.e. no identifiable cause found after routine examination but many known factors induce pericarditis , such as viral , bacterial , or fungal pathogens . Nearly , 80 % of the display case are triggered by viral transmission in the develop commonwealth . virus include Coxsackie virus , echovirus , and adenovirus ; but in the third world countriesHIV , tubercular pericarditis , histoplasmosis , Aspergillus , Candida , and Coccidioides are the most vulgar cause of pericarditis . Rest 20 % is due to sure disease like autoimmune disease ( systemic lupus erythematosusand rheumatic fever),Myocardial infarction , Trauma to the gist , Uremia(uremic pericarditis ) and Cancer sometimes , a very rare phenomenon also responsible for this term which admit medicines ( Nydrazid , cyclosporine , hydralazine , and anticoagulants ) and radiation .
Type of Chronic Pericarditis
Chronic gushing pericarditis and chronic constrictive pericarditis are the two key types of chronic pericarditis .
In chronic effusive pericarditis , the fluid between the two layer ( serosal and fibrous ) starts easy accumulates and become excess amount in the pericardiac space . In normal condition , the fluid normally accounts 30 to 50 millilitre , which tolerate the spirit to locomote freely within the pericardial theca . Most of the slip are idiopathic whereas known cistron include TB , breast and lung cancer , hypothyroidism , high lineage pressure sensation , coronary artery disease , cardiomyopathy , heart valve disorder , and bradycardia . A biopsy from the patients can able-bodied to square off the cause of chronic pericarditis — for instance , tuberculosis . The patient ’s exhibit discomfort in respiration , pain behind the sternum , and sometimes they feel burdensomeness and chest fullness .
Chronic limiting pericarditis is an exceptional condition , generally its effects in scrape like fibrous tissue paper mannikin throughout the pericardium . The hempen tissue tends to contract over the days , compressing the heart . The tissue paper compress inhibit the nitty-gritty to perform its normal purpose , thus precede to heart bankruptcy , vain abdomen , difficulty ventilation ( dyspnea ) , swell of legs and general weakness . Sometimes the excitement occur without symptoms . The main cause for this stipulation includes viral , TB bacterial pericarditis , post - operative ( including cardiac catheterization ) , transmissible , chemical trauma , and connective tissue paper upset .
continuing confining pericarditis can be cured by operating theater but several risks are associated and may result in death . Death due to surgery accounts 5 to 15 % of patient whose term is severe form .
Diagnosis, Treatment, and Management
Echocardiographycan able to detect the excess fluid and mark like tissue formation surrounding the heart . It also helps in diagnosing cardiac tamponade , also called as pericardial tamponade , a chronic effusive pericarditis experimental condition when fluid forms up in excessiveness and result in concretion of the affectionateness . Sometimes , a chest x - re is supportive which can able-bodied to detect atomic number 20 accumulation in the pericardium . Cardiac catheterization , magnetized resonance imaging or computed imaging can be used to determine the pericardium .
remotion of fluid by phonograph needle drainage or surgical drainage can help the patients to relieve symptom . Salt restriction and diuretics drugs also relieve symptoms especially in chronic constrictive pericarditis .
Recurrent pericarditis is the most disturbing ramification of pericarditis fall out within a class in 30 % of patients after the first incident of acute pericarditis . It may lead to cardiac tamponade or chronic constrictive pericarditis in some patients .
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