Constrictive pericarditis is a type of disease in which the pericardium is also fibrosed and hence feels stiff, turning nearly into a calcified rind around the heart. This will limit its ability to expand and fill up with blood, leading to shortness of breath (dyspnea), chest pain, and fatigue.
Constrictive pericarditis is caused by many possible causes, some of which include infections that can result from tuberculosis, radiation therapy, or autoimmune diseases such as lupus and rheumatoid arthritis. This condition often has early diagnosis and the right kind of treatment as part of the management to prevent further complications.
Understanding Constrictive Pericarditis
Constrictive pericarditis refers to the inflammation of the pericardium that becomes thick and inelastic. This prevents the heart from expanding during diastole. This condition is a poor performance of the heart and may eventually cause serious complications.
In most patients, the ability of the heart to pump oxygen-rich blood across the body becomes compromised. The patient may become dizzy and feels fatigued. Inability of heart movement seems to progressively become fatal unless the patient seeks treatment.
Shortness of Breath (Dyspnea)
The most common symptom is dyspnoea, which is really shortness of breath and worsens with being active. Due to a decline in the heart's ability to pump blood, fluid will build up in the lungs, and that is indeed going to become much harder to breathe.
Causes of Constrictive Pericarditis
Several things may cause constrictive pericarditis; these include infections, autoimmune disease and prior medical treatments such as radiation therapy, chemical, and surgical. Among the developing world, tuberculosis remains to be a common source of this illness. People with lupus, rheumatoid arthritis, Sjögren's syndrome, cancer are among the large cause in more developed areas.
Radiation therapy, whereby radiation is administered to kill cancer cells, also causes this. Radiation tends to damage the inner layer of the heart known as the pericardium and ultimately leads to scarring.
Common Symptoms of Constrictive Pericarditis
The common symptoms which may develop gradually in cases of constrictive pericarditis include the following:
Chest pain: This is because of the rigidity of the pericardium, which is unable to allow the heart a free movement inside the chest.
Fatigue: Most patients become highly lethargic with a heart that cannot pump enough blood all through the body.
Swelling in abdomen and lower limbs: Fluid accumulation in the abdomen and lower limbs directly owes to the failure of the heart to pump the blood in the system in an appropriate manner due to its failing condition Edema is the term for fluid accumulation.
Dizziness: Most patients feel dizzy due to a relative decrease in the flow of blood towards the brain.
Impact of Autoimmune Diseases and Infections
Diseases of immunity, which include lupus, rheumatoid arthritis, and Sjögren's syndrome, may also lead to constrictive pericarditis. The pericardium is being attacked mistakenly by the body. Other infections like tuberculosis cause inflammation within the pericardium. This inflammation contributes to its scarring or thickening.
Diagnostic Tests for Constrictive Pericarditis
There are a number of confirmatory tests that are used in the diagnosis of constrictive pericarditis to determine the level of the disease condition. These include:
Echocardiogram and Electrocardiogram
An Echocardiogram is useful in showing the pericardium as well as checking out the working of the heart. It will reveal the thickened pericardium and any indication of fluid build up in the heart cavity. The Electrocardiogram, or the ECG, watches out the electrical activity of the heart, which sometimes is a symptom of faulty function.
Heart Computerized Tomography (CT) Scan and MRI
A Heart computerized tomography (CT) scan will give an image of the pericardium in detail, demonstrating if it is thickened or calcified. A Heart magnetic resonance imaging (MRI) provides more detailed information on the structural and functional heart anatomy and may be useful in differentiating constrictive pericarditis from other diseases of the cardiac system.
Right Heart Catheterization
Sometimes, right heart catheterization is performed in order to find out the pressure in the heart chambers. This way, it would be possible to see how the stiffness of the pericardium is playing with the pumping efficiency of the heart.
Treatment for Constrictive Pericarditis
This is entirely based on the severity and underlying cause of the ailment. Mostly, people try drugs, but some always require surgical intervention.
Diuretics and NSAIDs
Diuretics are commonly prescribed to decrease fluid accumulation in the body, especially in the abdominal and lower legs. These help alleviate swelling and make a patient feel much more comfortable. In addition, NSAIDs or non-steroidal anti-inflammatory drugs could be administered to a patient to decrease inflammation in the pericardium and relieve pain.
Surgical Treatment in Germany: Pericardiectomy
If the medication is still insufficient, a pericardiectomy might be done. This surgery will remove part of the pericardium or sometimes the entire layer so that it can allow the heart to expand fully for efficient pumping of blood. Surgery is usually indicated in patients with severe symptoms.
Complications of Untreated Constrictive Pericarditis
If constrictive pericarditis is not treated, it might result in potentially fatal consequences including
Heart failure: The heart cannot pump blood out efficiently so that less blood and oxygen reach the body.
Arrhythmias or irregular heartbeat: The strain the heart goes through may lead to the development of arrhythmias.
Kidney disease or renal failure: As blood flow to the kidneys is reduced, their functions are compromised.
Liver disease: Reduced blood flow may cause liver congestion, thus causing harm to the liver.
Pulmonary hypertension: High blood pressure in the lungs can occur due to failure of the heart to pump properly.
Other Possible Complications
Constrictive pericarditis can also be associated with other complications, including:
Sepsis: This is a severe infection and can happen when the bacteria from other body parts find a way into the heart.
Fainting or coma: This is due to the heart not being able to pump the blood properly, thus leading to minimum oxygen to the brain.
Abnormal cells: There may sometimes be abnormal pericardial cell proliferation. This complicates the treatment.
New Treatments and Medicine Discoveries in Germany
New treatments of constrictive pericarditis are coming up in different parts of the world, and Germany is no exception to the advanced care mechanisms that can be found with treatment in Germany. Medical research and innovation have continued to advance new techniques and better results for patients with this condition.
Hospitals in Germany are at the top of innovative treatment, and this includes such minimal invasive treatments to treat constrictive pericarditis.
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