Exudative pericarditis: treatment, signs, causes, symptoms

Exudative pericarditis is an inflammatory process that affects the serous pericardium and is accompanied by an abundant accumulation of effusion. The main problem in diagnosing pericarditis is that patients often ignore symptoms until it becomes too late. To avoid this, learn about the symptoms and treatment of exudative pericarditis in advance by reading the article.

Features of the disease

In children, pericarditis is diagnosed extremely rarely: approximately 1% of cases. The most common cause of childhood pericarditis is viral diseases, for example, influenza or Epstein-Barra. In adults, the list of reasons is much greater, although in some cases they can not be established before the lethal outcome.

Children's and adult pericarditis are also symptomatic. So, in children, the disease is often manifested by heat, pain in the heart and high blood pressure. Treatment of pericarditis is the same for all groups.

Schematic diagram of effusive pericardium

Species and forms of

Usually, physicians use a classification according to ZM Volynsky, which distinguishes pericarditis:

• Acute:
  1. fibrinous or dry;
  2. effusive or exudative;
  3. with tamponade;
  4. without tamponade;
• Chronic:
  1. effusive;
  2. adhesive;
  3. is asymptomatic;
  4. with cardiac dysfunction of a functional nature;
  5. with lime deposits;
  6. constrictive;
  7. with fusions of an extrapericardial nature;

In turn, effeminate pericarditis, chronic and acute, is distinguished by the nature of the inflammatory fluid, and it can be:

• Serous. It consists of water and albumins, formed at the early stages of the disease.
• Serous-fibrous. It is distinguished by a high number of filaments of fibrin.
• Hemorrhagic. It appears against the background of severe damage to blood vessels, it contains a significant number of erythrocytes.
• Purulent. The composition contains enough leukocytes and parts of necrotic tissues.
• Putrid. It appears because of the ingress of anaerobic microflora into the effusion.
• Cholesterol. The effusion is characterized by a high cholesterol content.

So, what are the reasons for the appearance of exudative pericarditis in the medical history?

You can find out how ex-cardiac pericarditis looks like from the following video:

Causes of

In many cases it is impossible to determine the exact cause of exudative pericarditis. However, scientists have found that pericarditis is extremely rare in itself and, usually, is a consequence of some disease.

The etymology differs in different forms of the disease. So, the nonspecific form is often caused by bacteria and viruses like:

1. of staphylococcus;
2. streptococcus;
3. pneumococcus;
4. influenza;
5. ECHO;
6. by the Coxsackie virus;

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• The tuberculosis form often appears due to the penetration of bacteria from the lymph nodes into the pericardium.
• Purulent type often appears on the background of operations performed in the cardiac area, with infective endocarditis, when the patient is already undergoing immunosuppressive therapy, as well as with the breakthrough of the pulmonary abscess.
• Non-infectious forms of the disease occur parts in oncology, allergic processes like serum sickness, after mediastinal irradiation.

The risk group of those who can develop pericarditis is not only those in whose families the disease was observed earlier, but also patients with hypothyroidism, people with violation of cholesterol metabolism, and early infarction.

Symptoms and signs of exudative pericarditis

Symptoms largely depend on parameters such as:

• fluid accumulation rate;
• degree of compression of the heart muscle;
• severity of the inflammatory process in the pericardium;

The earliest symptom is a feeling of heaviness and aching pain in the chest. Gradually the fluid accumulates, because there are other symptoms like dyspnea, dysphagia, coughing, hoarseness. Pericarditis acquires symptoms similar to heart failure, for example, swelling in the face, neck. At a certain position, pericardial friction noise can be heard.

Depending on the cause of pericarditis, there are other symptoms such as:

1. chills;
2. fever;
3. hyperhidrosis;
4. decrease in appetite;
5. orthopnoe;
6. swelling of the veins of the neck;

There are no specific symptoms, therefore it is important to consult a doctor in time for the diagnosis of exudative pericarditis.

Diagnosis

Diagnosis of the disease begins with a check with the cardiologist. The doctor's task is to identify pericarditis and differentiate it from other cardiovascular diseases like heart attacks.

For differentiation, a history of symptoms is used, as well as an examination. Patients have a small protrusion of the anterior thoracic wall, edema in the precordial region, as well as a weakened or complete disappearance of the apical impulse.

To confirm the diagnosis, the following tests are prescribed:

• Chest X-ray. Detects an increase in shadows and smoothing of the heart contours, as well as a change in the shape of the organ against the background of a large volume of fluid.
• Echocardiography. It allows to find out whether there is free space between the pericardial sheets and diastolic separation, which indicates pericarditis.
• ECG.Shows the presence of a decrease in the amplitude of the teeth.
• Multi-helical CT.Helps confirm the presence of effusion and increase the thickness of the pericardial sheets.

A rare, but accurate study is puncture of the pericardium. Puncture is allowed to examine the pericardial fluid and with 100% probability to identify the disease.

Treatment

Treatment of exudative pericarditis is performed in a hospital and under the supervision of a physician. The basis of treatment is the taking of medications, but sometimes patients are shown surgery. Cure pericarditis therapeutic method, and even more so folk remedies, it is impossible.

Medication

Treatment of med.drugs is aimed at eliminating pericarditis and its causes. To eliminate pericarditis, the patient is prescribed:

• NSAIDs. Ibuprofen is often used because it rarely gives side effects. If pericarditis developed against ischemia, then ibuprofen replaces diclofenac and aspirin. Third-line drugs include indomethacin. Glucocorticosteroid preparations. Prednisolone is prescribed in cases of neglected patient status.

Together with this, the root cause is treated with antibacterial, cytostatic and anti-tuberculosis drugs. Hemodialysis can be used to purify the blood.

Operation

• Often pericarditis is accompanied by a very large volume of fluid. To pump it out, doctors use evacuation of the effusion through a biopsy. The liquid is pumped out by means of a needle, therefore the operation is completely safe.
• Sometimes drug treatment does not give results, in this case, appointed thoracotomy. The patient's thorax is dissected, and the pericardium is removed, without affecting the areas where the nerve passes. Mortality from such an operation is less than 10%.

Prevention of disease and recommendations

The main preventive medicine, warning pericarditis - competent treatment of viral diseases and / or their complications. It is also important:

1. to treat connective tissue diseases in a timely manner;
2. treat complications of myocardial infarction;
3. at the rate prescribed by the doctor, to treat cancer;
4. maximally avoid chest trauma;
5. use radiation protection if there is a risk of radiation damage to the body;

General recommendations are reduced to adherence to a healthy lifestyle and measures that promote the rise of immunity. So, it is important to observe moderate physical activity, especially cardio exercises, and also to monitor nutrition and weight, take vitamins at the rate.

Complications of

The most common complication of pericarditis( more than 40%) is cardiac tamponade. In this case, fluid accumulates between the leaves of the pericardium, which interferes with the normal functioning of the heart muscle. In about 30% of cases, pericarditis is complicated by paroxysmal atrial fibrillation or supraventricular tachycardia, but only if the inflammation passes to the myocardium.

Sometimes pericarditis changes its appearance, which is also a complication. Often the disease becomes chronic and constrictive.

Recurrent, idiopathic, adhesive, exudative and other types of pericarditis have their prognosis, and also affect the life expectancy of a person. We will talk about this in conclusion

Forecast

The prognosis in many respects depends on the cause of the appearance of the disease and treatment. Usually, it is estimated as favorable, as more than 70% of patients survive for 5 years. On the other hand, if a tamponade develops, the likelihood of a fatal outcome is high( more than 50%).

More information on exudative and other types of pericarditis will be provided to us by a well-known TV presenter in the following video: