Pericardial disease is serious and should be treated as so. It starts out with severe chest pain that usually radiates to the shoulders, neck and back. Sometimes the pain can ease slightly if the person sits up straight and then leans forward. Either way, this disease demands attention and treatment needs to be started as symptoms occur. Many times, an electrocardiogram (ECG) is taken to see what changes have taken place. From that, doctors can determine the treatment plan that is necessary and what they can do to relieve the pain the patient is now suffering.
There are varying types of pericardial disease, each with its own set of symptoms and treatment. One such type is pericardial effusion, which is an abnormal amount of fluid between the heart and the sac that surrounds the heart. Small amounts of this liquid are usually not harmful, but larger amounts can prevent the heart from working correctly.
One of the main causes of an effusion is a viral infection, but there are others such as cancer, injury to the heart or a heart attack. In some cases, the cause of the effusion cannot be found and these types are referred to as idiopathic effusions. Symptoms are chest pain, shortness of breath, fever, muscle aches and fatigue. Large effusions, which can be quite serious, have symptoms such as light headedness, shortness of breath, heart palpitations (when the heart beats abnormally fast) and having cool, clammy skin. Having an ECG or a chest x-ray will help diagnose the condition.
Anti-inflammatory drugs are given to bring relief for this condition; however, if a severe infection or heart impairment exists, then other measures must be taken. The fluid must be drained and there are two ways to accomplish this. The physician may insert a needle into the area of effusion to drain the liquid and bring relief. This procedure is referred to as a pericardiocentesis. The other option is for the physician to make an cut in the chest and cut directly into the effusion and then to drain it. This procedure will usually prevent the effusion from returning.
Another procedure that is done for the relief of pericardial disease is to a pericardiectomy, which is performed due to the fact that the outer sac of the heart (pericardium) becomes calcified and stiff. This situation does not allow the heart to stretch as it normally would and leads to having the blood back up behind the heart, since the chambers of the heart do not fill with blood, as they should. This condition leads to a swelling of the heart and the patient experiences symptoms similar to heart failure. It's always difficult to diagnose the cause of this condition, however experts now tend to think it occurs due to previous heart surgery or having had radiation to the chest. This procedure falls into the category of major heart surgery and although chances exist for complications with any surgery, this one has a tendency to cause bleeding problems, a necessity for blood transfusions and even heart failure itself. A hospital stay of five to seven days is normal after this procedure and patients report feeling better immediately after surgery, although the patient isn't considered back to normal until six to eight weeks have gone by.
There are a host of conditions that are associated with pericardial disease, each with its own symptoms, risks and treatment. However, as always, the patient's cardiologist is the ultimate authority when it comes to treating a disease such as this.