Pericardial Disease

The pericardium is a thin fibrous sac that encircles and envelops the heart while providing it structural support.

Acute pericarditis, pericardial tamponade, and pericardial constriction are some of the most significant pericardial diseases.

Causes

Acute pericarditis	Cardiac tamponade	Pericardial constriction
Idiopathic (cause is unknown) Infection Myocardial infarction Malignancy Renal failure Trauma Post-cardiac injury syndrome Radiation	Pericardial sac infection (viral or bacterial) Cancer Pericardial inflammation caused by a heart attack Trauma Autoimmune disease Reactions to specific medications or treatments Metabolic causes such as chronic kidney failure Open heart surgery	Cardiac surgery Mediastinal radiationtherapy Idiopathic constriction Tuberculosis Pericarditis

Signs and symptoms

Acute pericarditis	Cardiac tamponade	Pericardial constriction
Sharp pain in the chest, which may spread to the neck, arms, or left shoulder Pericardial friction rub characterised by high-pitched, squeaky or scratchy sounds	Nausea Shortness of breath Anxiousness Chest pain Shoulder discomfort Abdominal discomfort	Nausea Malaise Fatigue Exertional dyspnoea Reduced tolerance for exercise Abdominal discomfort Peripheral oedema Ascites Orthopnoea Paroxysmal nocturnal dyspnoea

Diagnosis

Acute pericarditis	Cardiac tamponade	Pericardial constriction
Evaluation of medical history Physical examination Electrocardiography (ECG) Echocardiogram Magnetic resonance imaging (MRI) Computed tomography (CT)	Physical examination Electrocardiography (ECG) Echocardiogram Chest radiography	Electrocardiography (ECG) Echocardiogram Brain natriuretic peptide (BNP) biomarker Chest radiography

Treatment options

Acute pericarditis	Cardiac tamponade	Pericardial constriction
Medicines e.g., combination therapy using nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine	Prompt drainage of pericardial fluid through pericardiocentesis	Medicines e.g., anti-inflammatory agents and diuretics Pericardiectomy (surgical excision of a portion or most of the pericardium)

Prevention

While pericardial diseases such as acute pericarditis and cardiac tamponade cannot be prevented, measures can be taken to reduce your risk of experiencing another acute episode or complication. These include:

Receiving immediate treatment
Adhering to the treatment plan recommended by your doctor
Looking after your heart by exercising frequently, eating healthily and maintaining a healthy weight

Visit your nearest Gleneagles Hospital to learn more about our Cardiology Services

References:

Pericardial disease. Circulation 2006;113(12):1622-32 [Accessed on 10 May 2022]
Pericardial disease: diagnosis and management. Mayo Clin Proc. 2010;85(6):572-93 [Accessed on 10 May 2022]
Pericardial disease. Available at https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/pericardial-disease/ [Accessed on 10 May 2022]
Cardiac tamponade. Available at https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cardiac-tamponade.html [Accessed on 10 May 2022]
Prevention and treatment of pericarditis. Available at https://www.heart.org/en/health-topics/pericarditis/prevention-and-treatment-of-pericarditis#: [Accessed on 10 May 2022]

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