Pericardial Disease

The pericardium is a thin fibrous sac/covering that surrounds and provides structural support to the heart.

Among the most important pericardial diseases include acute pericarditis, pericardial tamponade, and pericardial constriction.

What are the causes of pericardial disease?

Acute pericarditis	Cardiac tamponade	Pericardial constriction
Idiopathic Infection Renal failure Myocardial infarction Post-cardiac injury syndrome Malignancy Radiation Trauma	Viral or bacterial infection of the pericardial sac Cancer Inflammation of the pericardial sac from a heart attack Trauma Autoimmune disease Reactions to certain medicines or treatment Metabolic causes e.g. chronic kidney failure After open heart surgery	Cardiac surgery Idiopathic constriction Pericarditis Mediastinal radiation therapy Tuberculosis

What are the symptoms of pericardial disease?

Acute pericarditis	Cardiac tamponade	Pericardial constriction
Sharp chest pain that can radiate to the neck, arms, or left shoulder Pericardial friction rub with high-pitched, scratchy or squeaky sound	Chest pain Shoulder discomfort Abdominal discomfort Nausea Dyspnoea Anxious	Malaise Fatigue Decreased exercise tolerance Peripheral oedema Nausea Abdominal discomfort Ascites Exertional dyspnoea Orthopnoea Paroxysmal nocturnal dyspnoea

How is pericardial disease diagnosed?

Acute pericarditis	Cardiac tamponade	Pericardial constriction
Medical history Physical examination Electrocardiography (ECG) Echocardiogram Computed tomography (CT) Magnetic resonance imaging (MRI)	Physical examination Electrocardiography (ECG) Chest radiography Echocardiogram	Electrocardiography (ECG) Lab test: brain natriuretic peptide (BNP) biomarker Chest radiography Echocardiogram

What are the treatment options for pericardial disease?

Acute pericarditis	Cardiac tamponade	Pericardial constriction
Medications e.g., combination therapy with colchicine and nonsteroidal anti-inflammatory drugs (NSAIDs)	Prompt pericardial drainage by pericardiocentesis	Medical therapy e.g., diuretics and anti-inflammatory agents Pericardiectomy (surgical removal of part or most of the pericardium)

What are the prevention tips for pericardial disease?

Pericardial disease like acute pericarditis and cardiac tamponade cannot be prevented. However, you can take steps to reduce your likelihood of having another acute episode or complications by:

Getting prompt treatment
Following the treatment plan advised by your doctor
Taking care of your heart by eating healthily, doing regular exercise, and keeping a healthy weight

References

Pericardial disease. Circulation 2006;113(12):1622-32 [Accessed on 10 May 2022]
Pericardial disease: diagnosis and management. Mayo Clin Proc. 2010;85(6):572-93 [Accessed on 10 May 2022]
Pericardial disease. Available at https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/pericardial-disease/ [Accessed on 10 May 2022]
Cardiac tamponade. Available at https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cardiac-tamponade.html [Accessed on 10 May 2022]
Prevention and treatment of pericarditis. Available at https://www.heart.org/en/health-topics/pericarditis/prevention-and-treatment-of-pericarditis# [Accessed on 10 May 2022]