The inflammation of the outermost layer of the heart has many causes. This inflammation—referred to as pericarditis by a Cardiologist in Lahore needs proper evaluation for treatment and management. Typically, chest pain is the main presenting complaint of this heart condition and is quite treatable. Read on to know more about pericarditis, its types, causes and symptoms:

What is pericarditis?

The heart is surrounded by two pericardial layers that ensure that the heart is protected in its sac and separated from the other thoracic contents. This fluid-filled sac involves the outer parietal layer and the inner visceral layer. If this sac is impacted by trauma, infested by micro-organisms—bacteria, fungi, parasites, viruses—or impacted by autoimmune disorders, there is mild swelling that can cause them to rub against each other or against the heart, thereby producing pain.

Depending on the causative factor, pericarditis can be severe or mild. Typically pericarditis does not last long but rarely, there are serious consequences of pericarditis as the heart function is disrupted. There are many types of pericarditis, based on the cause.

What are the types of pericarditis?

Based on the cause, the types of pericarditis are:

• Viral pericarditis: viral causes lie amongst the most common ones for pericarditis. A simple viral chest infection can involve the pericardial layer and result in inflammation. This type of pericarditis goes away on its own, but medication is given to alleviate the symptoms.
• Tuberculous pericarditis: pulmonary tuberculosis may involve the pericardial layer to cause pericarditis. This type is more prevalent in developing countries, and those patients with concurrent HIV infection.
• Purulent pericarditis: this is a rare form of pericarditis due to bacterial infestation. Causes of this type of pericarditis include: hemodialysis, pneumonia and chemotherapy.
• Constrictive pericarditis: in this type of pericarditis, there is thickening of the pericardial layers, consequently making heart pumping difficult.
• Pericardial effusion & Cardiac tamponade: accumulation of excessive fluid between the pericardial layers constitute pericardial effusion, and when this volume increases rapidly, cardiac tamponade results. There are specific medical conditions—like kidney disease—behind this.
• Malignancy: pericardial involvement due to primary malignancy of the heart, and more often, metastatic cancers can cause inflammation and irritation. The most common culprits are lung cancers, breast cancers, lymphomas and leukemias.
• Pericarditis due to autoimmune diseases: Rheumatoid arthritis and Systemic lupus erythematosus along with other autoimmune diseases can result in pericardial involvement. In many cases, pericardial effusions also form.
• Post-MI pericarditis: after a heart attack, pericarditis can occur in 7 to 23 percent of cases. The chances of pericarditis with myocardial infarction area higher with a larger infarct. When thrombolytic medication is started timely after MI, the chances of pericarditis are greatly reduced.
• Hypothyroidism: as many as 4 percent of pericarditis cases are due to severe hypothyroidism. Consequently, the patient may develop pericarditis effusion as well.
• Radiation: one of the cardiac consequences of irradiation, of the chest, is pericardial disease. The higher the dose of radiation (especially more than 4000 rad), the higher the chances of pericarditis.
• Trauma: close to 1 percent of pericarditis cases are due to blunt, penetrating and non-penetrating trauma.

What are the symptoms of pericarditis?

The symptoms of pericarditis include:

• Chest pain: this pain is often stabbing and sharp in nature, in the center of the chest. The patient may complain that the pain travels to the shoulders. The pain increases on lying down and deep breaths.
• Fever: this is another common symptom of pericarditis. The patient also complains of weakness, and fatigue with this fever.
• Breathing problems: the patient has difficulty breathing in pericarditis, especially deep inspiration.
• Dry cough: in addition to breathlessness, there is dry cough without sputum in pericarditis.
• Abnormal heart rhythm: this presents as accelerated heart beat with feeling of ‘skipped beat’ or fluttering of the heart.
• Chronic pericarditis present with a combination of these symptoms with more severe disease-causing, dependent swelling and low blood pressure. This type needs thorough management by the Best Cardiologist in Rawalpindi.