There are various diseases that can exert a strongThe negative impact on the work of the main organ of the circulatory system is the heart. In this article, we will discuss one of the most common problems, which is called pericarditis. This disease is dangerous and deserves to be paid attention.
About what disease there is a speech
If we try to define scientifically thatsuch a pericarditis of the heart, the symptoms of which concern many people, then we can say this: this is an aseptic or infectious inflammation of the parietal and visceral sheets of the pericardium. But, to put it more simply, it is a chronic or acute form of inflammation of the outer shell of the heart (pericardium), the cause of which is rheumatic damage, the effect of infection or other kinds of influences.
In order to understand the essence of this disease, it makes sense to pay attention to information of a general nature.
Pericardium is a pericardial sac in whichis such an important organ as the heart. In this case, the very fact of active reduction in such a bag is possible due to its special structure, which prevents the appearance of strong friction.
Symptoms of pericarditis in adults are evidentprovided that the functioning and structure of the heart shell are violated. It is possible to accumulate in the pericardium effusion (secretion), which has a serous or purulent character. Such a fluid is defined as exudate. It is under its influence that the heart is squeezed because of which the performance of its direct functions is violated. Obviously, such a state is dangerous and can not be ignored.
If in the pericardium there is an excessive accumulation of fluid, then there will be a direct threat to human life. In this condition, it is possible to avoid a lethal outcome only with immediate intervention.
It is worth noting that such a disease manifests itself most often in women, less often in men. As for children, at an early age such diagnosis is rarely made, although this sometimes happens.
Before considering the symptoms of pericarditis in humans, it is worthwhile to find out what precedes the appearance of such a complicated disease.
It is necessary to understand the following fact - the accumulation of fluid can be a consequence of various processes in the body:
- complication of pathology of internal organs;
- a sign of diseases directly from the heart;
- the result of the injury;
- manifestation of general infectious diseases;
- a sign of systemic diseases.
But if we talk about the most common causes, then first of all attention should be paid to the impact of infection. In this case, the symptoms of pericarditis can be the manifestation of its various forms:
- non-infectious (nonspotent, aseptic).
In fact, we are talking about problems with the condition of the pericardial bag with the following diseases:
- such viral infections as influenza and measles;
- parasitic infestations;
- tuberculosis, provided that the infection spreads from the extrapulmonary tuberculosis or primary pulmonary focus;
- microbial diseases (septic processes, scarlet fever, tonsillitis);
- fungal infections.
In addition to the effects of these diseases, the symptoms of pericarditis can be the result of serum sickness or drug allergy.
To a separate group of problems of the pericardium, it is necessary to include those forms of pericarditis that develop under the influence of the emerging pericardial defects with the formation of diverticula and cysts.
Types of the disease
No matter how pericarditis symptoms look, they will always testify to the development of one of two key types of the disease: acute or chronic.
If we talk about the chronic form, we needpay attention to the fact that it is developing gradually and may not have been felt for several years. In this case, such a pericarditis has several common forms:
- Adhesive, or adhesive, during which scars and rations are formed;
- a mixed appearance of adhesions, fluid and scars;
- exudate, or exudative form, characterized by a large accumulation of fluid in the pericardial sac.
Acute pericarditis, the symptoms of which appear much faster, also has several key forms:
- effusive, with the formation of a significant volume of fluid (pus, bloody contents or blood plasma);
- fibrinous, or dry, characterized by a large accumulation in the pericardial cavity of an adhesive substance from the blood plasma (fibrin).
Constrictive and exudative pericarditis: symptoms
In order to respond in time to the disease andstart timely treatment, you need to know at least common signs of the problem. And if we talk about the exudative form of the pericardium bag, we need to pay attention to this: with such a problem, the fact of fluid accumulation is often found during the fluorographic examination, as well as using echocardiography.
If a tumor of the thorax was recordedor lungs, it also makes sense to suspect the development of pericarditis. A similar diagnosis can be made in patients with uremia, during which cardiomegaly develops for no apparent reason, and there is an increase in venous pressure.
A slightly different situation is with thisa problem, like constrictive pericarditis, whose symptoms at an early stage are often not actually noticeable. Significant signs of the disease make themselves felt already when a pericardial bag accumulates enough fluid to complicate the work of the heart. Explicit signs appear over time after physical exertion in the form of severe dyspnoea and increased fatigue. People with this problem can record the fact of sudden weight loss and a marked decrease in appetite.
There are other signs that point toconstrictive pericarditis of the heart. Symptoms may eventually resemble the effects of right ventricular heart failure. We are talking about ascites, peripheral edema, pain and heaviness in the right upper quadrant.
How is dry pericarditis manifested?
Speaking about this form of near-cardiac diseasebags, you need to pay attention to the fact that this problem is often preceded by myalgia or fever. But this does not limit the complexity that causes dry pericarditis. Symptoms with time appear in the form of pain, which is located in the chest area.
Such a symptomatology may persistfor several days and even weeks, expressing themselves quite clearly with the sternum. There are painful sensations in both hands or one upper limb, as well as in trapezius muscles. The pain becomes especially acute when trying to change the position of the body. When coughing, swallowing and breathing, unpleasant sensations can also make themselves felt.
In case of development of such problem, as drypericarditis, the symptoms are slightly weakened if the person occupies a sitting position. But if the patient lies on his back, the effect will be reversed - the state of health will worsen.
In some cases, the pain syndrome may be troubling 24 hours a day. In this case, irradiation will be observed in one or both hands. This condition can stimulate myocardial infarction.
In this case, the absence of those described above is possiblepainful sensations during the gradual development of the process of fluid accumulation. Most often, this condition is due to the formation of a problem with the pericardium on the background of tuberculosis, uremia, tumor lesions and after radiation exposure sessions.
But the pain syndrome is not the only symptom that is accompanied by dry pericarditis. There may be shortness of breath and signs of dysphagia.
With this form of the disease, the earliest and most obvious symptom is pain in the region of the heart. In this case, the place of origin and the strength of these unpleasant sensations can change.
Most often, the pain is observed in the lower part of the sternum or in the apex of the heart. Possible irradiation in the neck, left shoulder blade and arm.
When there is an exacerbation of pericarditis,symptoms manifest themselves in the form of very severe pain. This condition may resemble myocardial infarction or pleurisy. In some cases, the pain is aching and dull. Sometimes patients begin to feel heaviness in the heart.
If the pain in the heart is felt during an exacerbation, then, most likely, you have to deal with dry pericarditis.
When exacerbation is not excluded the appearance of dyspnea,which will indicate the presence of effusion in the pericardial bag. At the same time, the more liquid has accumulated in the pericardium, the greater will be the problems with breathing. In order to improve the state of health for a while you need to sit down. In this case, dyspnea will be markedly reduced due to the concentration of exudate in the lower part of the pericardial sac and, as a consequence, the pressure on the heart will decrease. The blood circulation eventually improves, and the patient feels relief.
Shortness of breath can be accompanied by a cough, and in some cases even vomiting.
How does pericarditis develop in children?
As mentioned above, such problems with the work of the heart at an early age are rare. Nevertheless, the risk of developing such a disease before the age of majority is possible.
So, what does pericarditis look like in children?Symptoms in such young patients, as in adults, are often signs of the development of another, underlying disease. Most often it's about the effects of various viruses. Significantly, the disease develops on the background of tuberculosis or rheumatoid arthritis. The cause of pain in the heart can be the effect on the children's body of connective tissue diseases, for example, systemic lupus erythematosus.
Another reason why, at an early agethere is a defeat of the pericardium bag - it is severe staphylococcal and, more rarely, septic processes. Immunological genesis is characteristic of most childhood pericarditis. In the case of the development of the so-called uremic pericarditis in severe renal failure, the disease can be toxic.
Problems with the pericardial bag in children withpurulent processes are most often metastatic. This means that they develop because either a breakthrough purulent focus in the pericardium from the myocardium, or because of hematogenous drift.
As for the general symptoms, it can include moderate cyanosis, shortness of breath, stitching pain in the heart and fever.
In the case of the development of dry pericarditis will belisten to the heart above the pericardial friction noise. Often, a dry form should be exudative and this should be prepared. In this state of pain and noise of friction disappear, but the dimensions of cardiac dullness expand and the condition as a whole worsens.
Here is how the child's pericarditis manifests.Symptoms and treatment in this case is only the competence of the doctor. Parents should not try to influence the body of their beloved child on their own. A quick visit to the hospital would be the best solution.
Of course, not all people are sosophisticated experts in medicine to independently determine the clear signs of dry pericarditis without the help of a doctor. That is why it is important to remember that in the conditions of modern medicine there is always an opportunity to undergo diagnostics with the participation of qualified physicians.
So, if the state of health worsened andsensations, even remotely resembling the symptoms of pericarditis, you should immediately go to a doctor who, during the examination, can determine the presence of external signs of the underlying disease and fever, including. With the help of palpation in the case of pericarditis, it is possible to detect the friction noise of the pericardial sac above the area of cardiac dullness.
As a rule, such noise is also listened toget a more accurate picture of the patient's condition. For this, a phonendoscope is used, which strongly presses against the chest. The patient at this time should be in a vertical position, holding his breath while exhaling.
For more accurate diagnosis, laboratory data as well as ECG readings can be used.
Symptoms of pericarditis on the ECG, especially in acutedry form, expressed as signs characteristic of subepicardial damage to the myocardium. If there is a significant accumulation of fluid, the signs of the disease for this type of diagnosis will be expressed by reducing the voltage of QRS complexes.
With a disease such as pericarditis, symptoms andtreatment requires a competent evaluation and approach. First of all, you need to provide bed rest. This rule is especially important in the case of diagnosing the exudative form of the disease. On average, such a regime lasts about a month and it can be expanded only if significant improvements in the patient's condition are noticeable.
If dry pericarditis was recorded, there is no acute need for a constant stay in bed.
But, going back to the exudative form, you neednote that with its aggravation, immediate hospitalization is necessary in the intensive care unit. The patient should be examined by a thoracic surgeon. As for nutrition during such a disease as pericarditis, this issue is regulated taking into account the underlying disease.
If the cause of fluid accumulation in the pericardiumbecame an infection, then antibiotic treatment can be prescribed. In the case of tuberculosis, the same drugs are also used, but this treatment will take considerably longer.
Often with problems with the pericardial bagan effect is determined by means of anti-inflammatory agents. To reduce the severity of pericarditis and neutralize the pain syndrome, nonsteroidal drugs such as Voltaren, Indomethacin, and others are relevant.
Glucocorticosteroids in addition to the aboveeffects can have an immunosuppressive and antiallergic effect. For this reason, they are defined as effective agents of pathogenetic therapy.
Such drugs are indicated in case of diagnosis of the following types of pericarditis:
- with myocardial infarction, it is Dressler's syndrome;
- in case of systemic diseases of connective tissue;
- if there is an active rheumatic process;
- with persistent tuberculous pericarditis;
- exudative form with an unexplained cause and accompanied by a severe course.
In most cases, a drug such as Prednisolone is prescribed. This course lasts, as a rule, several weeks with a gradual cancellation of the use of this tool.
Attention should be paid and puncture of the pericardium.It is about puncturing the cavity of the pericardium sac and evacuating the effusion, which creates pressure on the heart. Such a puncture is performed urgently in the event that there is a rapid accumulation of exudate leading to a threat of cardiac tamponade.
Puncture can also be performed with purulentform of the disease, after removing the liquid in the pericardium, antibiotics and other topical medications are administered by means of a needle.
Rapid accumulation of exudate can also lead toto the development of constrictive pericarditis. In this condition it is necessary to limit the intake of table salt to 2 g per day and significantly reduce the amount of liquid that the patient consumes. The appointment of diuretics is topical.
In especially severe cases,surgical intervention. It is used mainly in the absence of the desired result after drug treatment during constrictive pericarditis. When the patient's condition improves, the surgeon performs a pericardectomy in order to release the left ventricle of the heart from constant squeezing.
There are a number of alternative techniques for impacton a problem like pericarditis. Symptoms and treatment of folk remedies of this disease is an actual topic. But it is worthwhile to understand that replacing traditional methods with the main medical process is a big mistake. The accumulation of fluid in the pericardial bag is a problem, accompanied by rapid complications that can not be neutralized without competent diagnostics and qualified treatment.
Folk remedies are allowed only inrecovery period as an accompanying effect. But in any case, amateur performance is not welcomed, it is better to take all actions after consultation with the attending physician.
With regard to topical potions, it is acceptable decoctions of dog-rose, wild strawberry, hawthorn and St. John's wort.
For those who have pets, there will betopical topic: "Pericarditis in dogs: symptoms and treatment". In principle, problems with the pericardial bag may be in other animals. Symptoms with such a problem are reduced to the appearance of fever, soreness in the heart area, as well as general oppression of the animal that is sick. In general, the symptoms are similar to the course of the disease in humans, so with a depressed state of the domestic beast, it is better to take him to a veterinarian, otherwise you can face serious complications.
Symptoms of pericarditis in animals can appear after damage of various kinds. Therefore, if the beloved dog was injured, it is necessary to organize a check of his condition through time.
Pericarditis is serious enoughdisease, so you can not ignore it. For this reason, the common people should familiarize themselves with at least common symptoms. This will allow you to recognize a dangerous disease in time and consult a doctor. With this approach, there is every chance to undergo an effective treatment, warning of possible complications. Do not forget that if the fact of the accumulation of fluid near the heart does not affect, there may be a fatal outcome. So it's better to find time for an additional visit to the doctor.