Description pericarditis
Introduction to the issue
Pericardium or pericardium is a membrane that consists of two sheets, which is closed to form a tapered bag which urges the specific area of the diaphragm (center tendineum). Within this pouch is found heart with a small amount of viscous fluid, which facilitates the movement of this body. This fluid has a slightly yellowish color and is, about 20 ml.
As already mentioned above, the pericardium is composed of two sheets. Visceral sheet (epicardium) is directly attached to the muscle layer of the heart (myocardium). The second sheet, parietal (own pericardium) creates a cavity.
In the heart, which weighs about 300 grams, pericardium has an area of about 300-340 square centimeters. Pericardium has many functions, namely it is: maintaining a heart in a relatively fixed position, further minimizing friction between the heart and surrounding structures, to protect the heart against infection,directing the gravitational force that acts on the heart to facilitate the performance of arterial blood, to avoid excessive stretching (dilatation) heart and act on the pressure-volume relations of the heart cavities.
It follows that the pericardium is a relatively important structure. Most diseases that affects the pericardium, the secondary (secondary character). This means that the first (primary) is a heart disease, the surrounding organs or body is affected by systemic disease, and pericardium is affected secondarily, therefore due to an underlying disease.
Essential is the fact that despite the existence of many factors that can cause disease, a pathological response pericardium to these factors a very uniform and is basically twofold.Pericardium may react so that accumulated liquid in his bag or leads to its inflammation.Inflammation of the pericardium is called pericarditis. For completeness, I will describe two ways of responding to the pericardium harmful factors.
Accumulation of fluid in the pericardial sac is the first option pericardium response to pathological stimuli. As already mentioned above, the pericardium contains 20-30 ml viscous yellow liquid. Under pathological conditions may occur many times the increased amount of fluid. This fluid may be non-inflammatory nature of the fluid, blood or exudate (exudate is a liquid with a large amount of blood proteins).
Most often it is watery (serous) effusion, which is produced from a variety of causes .. Often, it is called for. Congestive heart failure or low blood protein – hypoproteinaemia. Hypoproteinaemia again arises from a variety of causes: from kidney reasons hepatic reasons and for nutritional reasons. Fluid accumulates most slowly. Its volume usually do not exceed 500 ml.
These are the reasons why hydropericardium (serous pericardial effusion) usually causes no clinical symptoms or manifestations. The symptoms may occur if the effusion many – eg. Through one liter, then it can cause a phenomenon called cardiac tamponade, when the diastolic (phase cardiac activity when the muscle relaxes and the performance occurs cardiac chambers with blood) thanks to great pressure and compression of fluid compresses the veins and the diastolic filling said compartments heart does. This situation is very unfavorable and must be treated evacuationpuncture.
Rarely, it may be the content of the pericardium consists lifeblood – lymph. This occurs whentumors in the thoracic and for blocking the main mízovodu (thoracic duct). This condition is called professionally chyloperikard.
Haemopericardium is a condition that indicates the presence of pure blood in the cavity of the pericardium. The intrusion of blood may occur via two pathways: rupture (fissure) wall of the left ventricle, which is the result of acute myocardial infarction and in the state, which is known asaortic dissection.
Pericarditis can be divided according to cause, or by type of inflammatory exudate produce. The vast majority of noninfectious pericarditis is called charakteru-. Aseptic pericarditis. Inflammation of the pericardium often arises above the bearing myocardial infarction. This is called myocardial infarction. Transmural, i.e. penetrating a wall of the left ventricle. This type of inflammation of the pericardium has a specific name – pericarditis epistenocardiaca.
Pericarditis can occur even after surgery on the heart, especially if they occur at the opening of the pericardial cavity (perikardotomie).
Other reasons are called pericarditis. Connective tissue diseases and malignant tumors.Radiation may also cause inflammation. Numerous Pericarditis occurs without a known cause us – about such inflammations are talking about as idiopathic perikarditidách.
When you attack the pericardium certain infectious agents are talking about infectious perikarditidách. Their most common causative viruses. These viruses are coxsackieviry A and B, echoviruses. Furthermore, it purulent microbes: staphylococcus and pneumococcus, as it isMycobacterium tuberculosis, the causative tuberculosis etc.
According to another division we can distinguish pericarditis dry (pericarditis sicca or fibrinous) and already mentioned exsudační (production of inflammatory exudate, which is a liquid with a large amount of blood proteins).
After an acute inflammation of the pericardium pericardium can heal without any problems. In other cases not heal and may be formed adhesions. During extensive adhesions leads to constriction of the heart, and then we talk about. Constrictive pericarditis. Constrictive pericarditis also may complicate so that these adhesions stored calcium ions (calcium), so there may be up to produce the image of the armor of the heart (pericarditis Calcarea).
Signs and symptoms of pericarditis
Pericarditis have several major symptoms. It appears chest pain, temperature. When listening with a stethoscope appeared rub.
They are also important changes in ECG (concave ST segment elevation after normalization of the ST segment, T wave inversion then etc.). When echocardiography can be seen effusion and thickening of the walls.
treatment of pericarditis
Treatment effusion or any liquid being treated so. Evacuation puncture when impaled wall of the pericardium and the contents evacuated.
Acute pericarditis is treated with anticoagulants (ie. Pelentanizace). Generally, treatment is governed inflammation causes disease.
Dry pericarditis is treated only painkillers, inflammation and effusion (its production) will dampencorticosteroids.
Constrictive pericarditis or pericardial tumor involvement is treated with surgery.
In infections should be given appropriate antimicrobial agent according to sensitivity.
How can I help myself
In dry pericarditis treatment with paracetamol, ibuprofen, etc. Bed rest during treatment, strict adherence to doctor’s instructions.
complications of pericarditis
The most serious complication is the emergence of cardiac tamponade. When it decreases diastolic filling, and it follows that there is a dramatic decrease in cardiac output.
Symptoms that arise from reduced cardiac output, are: shortness of breath (feeling that one can not breathe), anxiety, dizziness, sweating, low blood pressure and shock.
Furthermore, it’s jugular vein distension, liver enlargement, diminished punch tip ozvi weakened heart, increased heart rate (tachycardia) and hypotension. ECG Demonstrate reduced voltage ventricular complexes.
Other names: pericarditis, pericarditis, pericarditis, aseptic pericarditis, pericarditis epistenocardiaca, infectious pericarditis, constrictive pericarditis, constrictive pericarditis, calcarea pericarditis, idiopathic pericarditis