Pericarditis is an irritation, inflammation, or swelling of the pericardium, a thin layer of tissue that surrounds the heart (Acton, 2012). The condition is generally acute, develops unexpectedly, and may last for a few months. In some cases, excessive fluid may develop amid the strata and result in a pericardial effusion (Acton, 2012).
The risk factors of pericarditis include a previous viral infection, such diseases as kidney failure or lupus as well as a preceding heart surgery. Others encompass trauma, uraemia, paraneoplastic syndromes, post-radiotherapy, and post-myocardial infarction.
The signs of pericarditis include dry cough or swelling of the legs or feet (Tingle, Molina, & Calvert, 2007). The swelling is a sign of constrictive pericarditis, a severe kind of pericarditis. It is characterized by the hardening or thickening of the patient’s pericardium, something that prevents the heart muscle from enlarging. This affects the general functioning of the heart.
The symptoms of pericarditis encompass sharp and stabbing chest pain, pain in the neck, back or left shoulder, fatigue or anxiety, and difficulties in breathing while lying down (Tingle, Molina, & Calvert, 2007).
In order to establish a diagnosis, the physician starts by assessing the symptoms. Difficulty in breathing and sharp pain both at the shoulders and in the chest are the key indicators which differentiate pericarditis from a heart attack.
The diagnosis also includes an enquiry about the medical history of the patient, a preceding heart surgery, as well as present illnesses such as kidney failure that may amplify the danger of pericarditis.
While conducting a physical exam, the physician listens to the heart using a stethoscope. The physician may hear the pericardial rub, a creaking sound caused by the rubbing of the inflamed lining, and fizzes in the lungs due to the surfeit fluid trapped in the pericardium or around the lungs.
Diagnostic tests are also used. They encompass chest X-ray that indicates proof of swelling of the heart. It also shows whether the lungs are congested.
Another test is electrocardiogram (ECG) that confirms the modifications in the normal rhythm of the heart that may be an indication of pericarditis (Tingle, Molina, & Calvert, 2007). Besides, a CT scan or cardiac MRI shows whether there is surfeit fluid in the pericardium or thickened pericardium that may result in the constricting of the heart.
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An echocardiogram may be used to test the functioning of the heart. It shows proof of pericardial effusion surrounding the heart. Additionally, it witnesses typical signs of pericarditis such as thickening or stiffening of the pericardium which restricts the normal movement of the heart.
Lastly, laboratory tests, especially blood tests are carried out to ensure that the patient is not suffering from a heart attack. It involves testing the fluid and determining the primary cause of the condition.
For acute pericarditis, medication is prescribed to relieve pain and reduce inflammation. They include nonsteroidal anti-inflammatory drugs (Troughton, Asher, & Klein, 2004). The physician may also recommend an antibiotic or an antifungal medication, but it depends on the cause.
In case of recurring symptoms, the physician may recommend colchicine, an anti-inflammatory drug, alongside ibuprofen. The former helps in controlling the inflammation while preventing the recurrence of pericarditis for several months.
For chronic pericarditis, patients are required to use colchicine or nonsteroidal anti-inflammatory drugs for years. This kind of treatment requires monitoring through regular follow-up appointments to assess the functioning of liver or kidney. However, the condition affects only a small number of people.
In addition to medications, such procedures as pericardiocentesis or pericardial window are used to remove surfeit fluid from the pericardium.
Pericarditis is caused by idiopathic causes, thus, it is difficult to prevent the disease process. However, the patient can take necessary steps to lessen the likelihood of having a similar acute episode, getting chronic pericarditis or having complications (Troughton, Asher, & Klein, 2004). Such steps encompass prompt treatment, a treatment plan and continuous medical care.
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