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Pericardial Disorders

What are pericardial disorders?

The pericardium is a membrane that surrounds your heart. It holds the heart in place and helps it work properly. Problems with the pericardium include:

  • Acute pericarditis, an inflammation of the sac. It can be from a virus or other infection, a heart attack, heart surgery, other medical conditions, injuries, and certain medicines.
  • Pericardial effusion, the buildup of fluid in the sac.
  • Cardiac tamponade, a serious problem in which buildup of fluid in the sac causes problems with the function of the heart. It can be from a tumors, uremia, or the accumulation in the blood of waste materials that are usually eliminated in the urine, bleeding into the pericardium because of surgery or injury and bleeding caused by anticoagulants in patients with acute pericarditis. .
  • Chronic constrictive pericarditis, the persistence of pericaditis.

Both chronic and acute pericarditis can be life threatening. Many of the symptoms of pericarditis are similar to those of other heart and lung conditions. The sooner you are evaluated, the sooner you can receive proper diagnosis and treatment. For example, although the cause of acute chest pain may be pericarditis, the original cause could be a heart attack or a blood clot of the lungs (pulmonary embolus).

What are the symptoms?

Symptoms of pericardial problems include chest pain, rapid heartbeat and difficulty breathing. Fever is a common symptom of acute pericarditis. Treatment depends on the cause.

Most common symptoms of acute pericarditis are:

  • Chest pain, tightness or pressure
  • Pericardial friction rub or murmur
  • Excessive fluid aound heart
  • Dull-chest pain
  • Low-grade fever

Most symptoms of cardiac tamponade include:

  • Rapid heartbeat
  • Difficulty breathing
  • Severe drop in blood pressure
  • Weak pulse
  • Decreased heart sounds
  • Distended or bulging veins
  • Bluish skin color, or cyanosis
  • Severe anxiety or panic

Most symptoms of chronic constrictive pericarditis include:

  • Fatigue
  • Weakness
  • Shortness of breath
  • Weight loss
  • Loss of appetite
  • Liver enlargement
  • Distended neck veins
  • Ascites, or the accumulation of fluid in the abdomen
  • Edema, or the accumulation of fluid in the extremities

Chest pain that accompanies pericarditis may be worsened by lying down, coughing, breathing deeply, and sometimes by swallowing.

How is it treated?

  • Medication. The physician may treat acute pericarditis by prescribing medications, including:
    • Nonsteroidal anti-inflammatories (NSAIDs), such as aspirin or ibuprofen
    • Morphine or codeine
    • Antiarrhytmic drugs
    • Antibiotics
    • Corticosteroids
  • Pericardiocentesis (pericardial tap). To prevent fluid reaccumulation, a needle and catheter are sometimes inserted into the pericardium to remove fluid from the sac around the heart. This procedure relieves pressure on the heart and the catheter may be left in place for several days. The fluid may then be sent to a laboratory for tests to look for signs of infection or cancer. If the fluid re-accumulates, the physician may consider surgery to remove a portion of the pericardium so that fluid drains continuously.
  • Surgery. Removal of the stiffened pericardium in a procedure called pericardiectomy is the only cure for chronic constrictive pericarditis.

What is Lee Health's approach?

At Lee Health, we use advanced imaging tests to accurately diagnose peripheral artery disease. We work together to evaluate and treat your condition.

Our doctors have expertise treating people who have pericardial disorders using medications, pericardiocentesis, and pericardiectomy. Our doctors work with you to determine the most appropriate treatment for your condition.