Pericarditis

The pericardium is a double-layered membrane that surrounds the heart and the associated blood vessels. The outer layer, called the fibrous pericardium, anchors the heart in place and prevents it from overexpanding. The inner layer, or serous pericardium, consists of two layers: the parietal pericardium, which is beneath the fibrous pericardium, and the visceral pericardium (or epicardium), which directly covers the heart. Between these layers lies the pericardial cavity, which contains a lubricating fluid, the pericardial fluid, which reduces friction during heart contractions.

Pericarditis is the inflammation or infection of the pericardium and can be caused by various factors such as viral or bacterial infections, autoimmune diseases (such as lupus and rheumatoid arthritis), kidney failure, thyroid diseases, chest trauma, myocardial infarction, medications, chest radiotherapy, or neoplasms, including metastases.

Main signs and symptoms of pericarditis:

• Chest pain;
• Difficulty breathing;
• Palpitations;
• Fever and fatigue;
• Persistent cough and generalised oedema.

The diagnosis is based on the evaluation of symptoms, clinical history, physical examination, and complementary tests such as electrocardiogram and echocardiogram. Pericarditis can be classified as acute (lasting 4-6 weeks) or chronic (lasting over 3 months). Treatment aims to alleviate symptoms, reduce inflammation, and address the underlying cause, if identified.

If not properly treated, pericarditis can progress to constrictive pericarditis (decreased elasticity of the pericardium, affecting heart function) or cardiac tamponade (accumulation of fluid in the pericardial cavity), conditions that can be fatal. In such cases, hospitalisation and specialised treatment are necessary.