Are you experiencing shortness of breath, coughing, and fatigue every day? If yes, chances are you might have developed chronic pericarditis. It is a chronic condition that occurs when gradual, long-lasting inflammation of the pericardium causes accumulation of fluid in the pericardial space or thickening of the pericardium, which compresses the heart and prevents it from functioning properly. This can be life-threatening if it’s symptoms are not managed. Luckily, in most cases, treatment can cure this condition. Learn how to manage long-term symptoms of chronic pericarditis in this article. Get a consultation with the best cardiologists in Brooklyn.
Types
There are mainly two types of Chronic Pericarditis, including:
- Chronic effusive pericarditis: In this type of chronic pericarditis, fluid slowly builds up in the pericardial space, between the 2 layers of the pericardium.
- Chronic constrictive pericarditis: This is a rare type of chronic pericarditis that occurs when fibrous tissue forms throughout the pericardium. These tissues tend to contract over the years, which compresses the heart. This compression prevents the heart from working normally and causes a form of heart failure. Additionally, the heart doesn’t enlarge as it should in these forms of heart failure because high pressure is required to fill the compressed heart. Pressure in the veins that return blood to the heart increases. As a result of increased venous pressure, fluid leaks out and accumulates in other areas of the body, such as under the skin.
Symptoms
Chronic pericarditis causes symptoms like:
- Shortness of breath
- Coughing
- Fatigue
Shortness of breath and coughing happens when the high pressure of the lung’s veins forces the fluid into the air sacs. Fatigue happens when the abnormal pericardium interferes with the heart’s pumping action, which makes it difficult for the heart to pump enough blood to meet the body’s needs.
Other common symptoms are fluid accumulation in the abdomen (ascites) and the legs (edema). Sometimes, the fluid accumulates in the space between 2 layers of the pleura, the membranes that cover the lungs, called pleural effusion. Chronic pericarditis doesn’t cause pain, but sometimes inflammation occurs without symptoms.
If the fluid accumulation happens slowly, the pericardium can stretch slowly causing few symptoms and severe pressure on the heart (cardiac tamponade) may not develop. However, if fluid accumulates rapidly, or the pericardium is not able to stretch sufficiently, it compresses the heart and leads to cardiac tamponade.
Management
To manage chronic pericarditis, doctors first try to treat the underlying disorder that causes the condition. Sometimes, in chronic constrictive pericarditis, surgery is required to remove the pericardial fluid or the pericardium. In transient cases, it may be reversible with empirical anti-inflammatory therapy.
For chronic effusive pericarditis, the doctor treats the known causes as soon as possible. In case your heart works normally, then the doctor uses a wait-and-see approach. If the disorder causes symptoms or infection is suspected, balloon pericardiotomy, needle drainage (pericardiocentesis), or surgical drainage may be done to remove the fluid or the pericardium to manage the infection.
For chronic constrictive pericarditis, you need to restrict the salt in the diet and diuretics to relieve the symptoms. If you have an inflammatory and reversible pericardial reaction, then the doctor may treat the underlying cause and use anti-inflammatory medications. If patients don’t see an improvement in medical treatment for a period, then pericardiectomy is recommended. This is the only feasible way to cure chronic constrictive pericarditis. Early pericardiectomy is used to remove fibrous tissue to improve symptom relief and treat constrictive pericarditis before it turns into severe constriction or myocardial atrophy.
While surgery cures most people, it also carries a 5 to 15% risk of death from surgery. Most people don’t have surgery unless the disease interferes with their daily life activities. Doctors usually wait until symptoms are severe to make the surgery effective.
Chronic pericarditis occurs when inflammation of the pericardium starts gradually and causes long-lasting results of fluid accumulation in the pericardial space or thickening of the pericardium. This condition causes chronic symptoms which can be life-threatening. However, it is curable with pericardiectomy, a surgical procedure of removing pericardium fluid as much as possible. This surgery is only recommended when your chronic pericarditis symptoms get severe and interfere with your everyday life. Otherwise, treatment focuses on managing your long-term symptoms with anti-inflammatory medications and salt and diuretic restriction.
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