Pericarditis is an inflammatory disease of the pericardial sac also known as pericardium. It is an external tissue shell of the heart or “heart sac” that surrounds the great vessels of the chest (aorta and pulmonary artery) and, of course, the heart. Pericardium consists of the inner and outermost layers, the space between these layers is called pericardial cavity and it is filled with fluid. This fluid plays the role of a lubricant that allows the heart to slide easily when contracting.
Pericarditis is not always diagnosed while a patient is alive, in about 3-6% of cases the signs of pericarditis are detected at post-mortem examination. Pericarditis may develop at any age but more often it is observed in adults and elderly people and, by the way, its incidence is higher in women than in men. It can progress as an independent isolated disease or as a complication of the diseases of other body organs and systems.
How dangerous is pericarditis?
This disease may be the cause of the following complications:
- Development of pericardial adhesions or the pericardium can get fused with other organs of the chest.
- Proliferation of the connective tissue in the pericardium, salts of calcium get deposited there and that leads to the formation of a thick coat around the heart called "armored heart".
- Cardiac tamponade - a condition when the heart is like “choking” with its own blood.
- Enlarged heart may compress the veins of the liver causing false liver cirrhosis.
- Pericarditis, affecting other heart layers with inflammation, causes myocarditis and endocarditis, or the inflammation of all the layers of the heart simultaneously – pancarditis.
- Due to the scarring of the pericardial tissues, the heart and its layers may get fused with other organs of the chest and the backbone.
Depending on the cause, there are two kinds of pericarditis:
- Primary pericarditis – such inflammations appear on their own, but they are quite rare;
- Secondary pericarditis – these inflammations appear as complications of other diseases of the chest, abdominal cavity and blood.
Depending on the course of the disease, there are:
- Acute pericarditis– they progress quite rapidly and last no longer than 3 months. Acute pericarditises are divided into:
- Fibrinous (dry) pericarditis – it is characterized by the deposition of fibrin in the pericardial cavity. This condition usually lasts from 2 to 3 weeks and after this period of time it is either cured or transformed into effusion (or adhesive) pericarditis;
- Pericarditis with effusion – it is characterized by the accumulation of the fluid in the cavity of the pericardium;
- Chronic pericarditis – they progress slowly and last over 3 months. Chronic pericarditises are divided into:
- Pericarditis with effusion (effusive pericarditis) – it is usually a complication of a dry pericarditis;
- Constrictive pericarditis (aka adhesive pericarditis) – a condition when the walls of the pericardium stick together and form adhesions;
- Effusive-constrictive pericarditis – it is quite a rare condition characterized by the development of effusive pericarditis together with constrictive pericarditis.