Chronic Diseases Pericardium

The chronic pericarditis is inflammation resulting from accumulation of fluid in the pericardium or pericardial thickening. It has a gradual onset and persisting for an extended period of time. In the case of chronic pericarditis with effusion, there is a slow accumulation of fluid in the pericardium. The condition can be caused by cancer, tuberculosis or hypothyroidism.
When possible, the known causes are addressed and, if cardiac function is normal, your doctor may adopt a waiting, watching the evolution. Chronic constrictive pericarditis is a disease that occurs when there is formation of a fibrous tissue (scar) around the heart.
The fibrous tissue tends to shrink over time, compressing the heart and reduces its size. Compression increases pressure in the veins that return blood to the heart because more pressure is needed to fill it. There is an accumulation of fluid and then an escape, with the appearance of edema in the lower limbs, abdomen and sometimes in the space around the lungs.
Causes:
Any condition that causes acute pericarditis can cause chronic pericarditis, but usually the cause is unknown. The most common known sources of chronic pericarditis constrtiva are viral infections, tuberculosis and radiotherapy used in the treatment of breast cancer or lymphoma. The chronic constrictive pericarditis can also be caused by rheumatoid arthritis, systemic lupus erythematosus, some previous injury or a bacterial infection.
Previously, tuberculosis was the most common cause in the United States, but currently, it accounts for only 2% of cases. In Brazil, Africa and India, tuberculosis is still the most common cause of all forms of pericarditis.
Signs and symptoms:
chronic pericarditis cause dyspnea (difficulty breathing), cough (because the high pressure in the veins of the lungs pushes fluid into the air spaces) and fatigue (because the heart works so poor). Moreover, the disorder is painless. Also common is the accumulation of fluid in the abdomen and lower limbs (edema).
Diagnosis:
Symptoms provide important clues for diagnosis of chronic pericarditis, particularly if there are other reasons for the decrease in cardiac performance. Generally, in the case of chronic constrictive pericarditis, heart is not increased in chest radiographs, unlike what happens in most other heart diseases.
About half of people with chronic constrictive pericarditis has calcium deposits in the pericardium, which are observed in the chest X-ray. Two types of procedures can confirm the diagnosis. Cardiac catheterization is used to measure blood pressure in the heart chambers and major blood vessels.
Optionally, the doctor can make use of magnetic resonance tomography or cardiac heart, to measure the thickness of the pericardium. In general, the thickness of pericardium is less than 3 mm, but in chronic constrictive pericarditis it can reach 6 mm or more.
Treatment and prognosis (severity):
Although diuretics (drugs that promote the elimination of excess liquid) assist in reducing the symptoms of chronic pericarditis, the only possible treatment is surgical removal of the pericardium. The surgery healing about 85% of persons undergoing the procedure. However, as the risk of life is 5 to 15%, the majority of affected people opt for surgery when the disorder interferes substantially with the daily activities.