Symptoms of cardiac pericarditis and treatment. Dry Pericarditis: Symptoms

There are various diseases that can have a strong negative impact on the work of the main organ of the circulatory system - the heart. This article will deal with 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 you try to define scientific language, what is pericarditis of the heart, the symptoms of which concern many people, then we can say the following: 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 which is located 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 make themselves felt, provided 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 this 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 occurs.

Causes

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 effect of infection. In this case, the symptoms of pericarditis Can be the manifestation of its various forms:

- Infectious-allergic;

- infectious;

- non-infectious (nonspotent, aseptic).

In fact, we are talking about problems with the condition of the pericardium 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 may result from 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 need to pay attention to the fact that it develops gradually and may not be felt for several years. In this case, such pericarditis has several common forms:

- Adhesive, or adhesive, during which scars and rations are formed;

- a mixed appearance of adhesions, fluid and scars;

- effusive, or exudative form, characterized by a large accumulation of fluid in the pericardial bag.

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 timely respond to the disease and begin 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 that: with such a problem, the fact of fluid accumulation is often found during the fluorographic examination, and also with the use of echocardiography.

If a tumor of the chest or lung has been fixed, 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.

Somewhat differently the situation is with such a problem as constrictive pericarditis, the symptoms of which 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 with time after physical exertion in the form of severe dyspnea and increased fatigue. People with this problem can record a sudden weight loss and a marked decrease in appetite.

There are other signs that indicate a constrictive pericarditis of the heart. Symptoms may eventually resemble the effects of right ventricular heart failure. It is about ascites, peripheral edema, pain and heaviness in the right upper quadrant.

How is dry pericarditis manifested

Speaking of this form of pericardial bag, one should 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 eventually manifest themselves in the form of pain, which is localized in the region of the chest.

Such a symptomatology can persist for several days and even weeks, expressing itself 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 the case of a problem such as dry pericarditis, the symptoms slightly weaken 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 can be troubling around the clock. In this case, irradiation will be observed in one or both hands. This condition can stimulate myocardial infarction.

In this case, the absence of the above-described pain sensations is possible during the gradual development of the fluid accumulation process. 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.

Acute pericarditis

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, the 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, it is necessary to deal with dry pericarditis.

With an exacerbation, dyspnoea appears, 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 decrease significantly due to the concentration of exudate in the lower part of the pericardium bag and, as a consequence, the pressure on the heart itself will decrease. The blood circulation eventually improves, and the patient feels relief.

The dyspnea itself may 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 and the effect on the child's body of connective tissue diseases, for example, systemic lupus erythematosus.

Another reason why at an early age a pericardial sac is affected 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 with purulent 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 pains in the heart and fever.

In the case of the development of dry pericarditis, the pericardial friction noise will be heard over the heart. Often, a dry form should be exudative and this must 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's 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.

Diagnostics

Of course, not all of the townsfolk are so sophisticated 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 medics.

So, if the state of health worsened and there were sensations even remotely resembling the symptoms of pericarditis, one 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 heard to get 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 an upright 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 its acute dry form, are 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.

Treatment

With a disease such as pericarditis, symptoms and treatment require a competent evaluation and approach. First of all, you need to provide bed rest. This rule is especially relevant in the case of diagnosing the exudative form of the disease. On average, such a regime lasts about a month and can only be expanded if significant improvements in the patient's condition are noticeable.

If there was a dry pericarditis, there is no acute need for a constant stay in bed.

But, returning to the exudative form, it should be noted that with its aggravation, immediate hospitalization in the intensive care unit is necessary. The patient should be examined by a thoracic surgeon. With regard to nutrition during a disease such as pericarditis, this issue is adjusted taking into account the underlying disease.

If the cause of fluid accumulation in the pericardium is an infection, antibiotic treatment may be prescribed. In the case of tuberculosis, the same drugs are also used, but this treatment will take considerably longer.

Often, in case of problems with the pericardium, an effect is administered by means of anti-inflammatory drugs. 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 above effects 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 remedy.

Attention should be paid to the 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 if there is a rapid accumulation of exudate leading to a threat of cardiac tamponade.

Puncture can also be carried out with a purulent form of the disease, after removing the liquid into the pericardium, antibiotics and other topical medications are administered by means of a needle.

Rapid accumulation of exudate can also lead to 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 diuretic drugs is topical.

In particularly severe cases, surgical intervention can be performed. 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.

Folk remedies

There are a number of alternative techniques for influencing a problem such as 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 diagnosis and qualified treatment.

Folk remedies are allowed only in the recovery period, as an accompanying impact. But in any case, amateur performance is not welcome, it is better to take all actions after consulting with the doctor in charge.

As for the actual potions, then acceptable are decoctions of rose hips, strawberries, hawthorn and St. John's Wort.

For those who have pets, the topic will be relevant: "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, and general oppression of the animal that is sick. In general, the symptoms are similar to the course of the disease in humans, so when a depressed state of the domestic beast is better to take him to the vet, otherwise you can face serious complications.

Symptoms of pericarditis in animals can appear after damage of various kinds. Therefore, if a pet dog is injured, it is absolutely necessary to organize a check of its condition through time.

Results

Pericarditis is a serious enough disease, therefore it can not be ignored. For this reason, it is worthwhile for the common people to get acquainted with at least general 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 work, a fatal outcome may occur. So it's better to find time for an additional visit to the doctor.