Among the various cardiac diseases, exudative pericarditis is distinguished, which provokes physiological changes in the superficial tissues of the heart.
An alternative name for the disease is exudative pericarditis, which is characterized by a dangerous accumulation of fluid in the walls of the pericardium.
Timely diagnosis of this disease helps to begin adequate treatment and to exclude fatal development of events.
Features of the disease
Inflammation in the heart with exudative pericarditis capturesa cardiac bag, the increase in which leads to the squeezing of the heart .Severe circulatory disorders lead to a deterioration in the quality of life, and in extreme cases - the death of the patient.
The stages depend on the timing of the disease:
- up to 6 weeks - acute stage;
- from 6 weeks to 6 months - subacute;
- over half a year is a chronic form.
Disturbance of metabolic processes in the heart of results in accumulation of fluid in the volume up to 1-2 liters( norm - 20-30 ml) of , which significantly compresses the nerve endings and adjacent organs.
Unlike hemorrhagic and serous-hemorrhagic types, does not increase the number of red blood cells .
Diagnosis of exudative pericarditis increases with the diagnosis of cardiac diseases. Sad data: among the total number of autopsies about 5-6% indicates the presence of problems with the pericardium .The detection of these pathologies is lower, which indicates a low percentage of treatment of citizens in the presence of the first signs of the disease.
Causes, at-risk groups
Accumulation of fluid in the pericardium occurs against the background of the influence of other pathologies - the itself is rarely an ailment.
The development of the disease occurs due to the ingestion of specific virus pathogens and the emergence of infectious diseases. Typhoid fever, smallpox, tuberculosis, tularemia, pneumonia are diseases that negatively affect the pericardium.
Surgical interventions on the heart similarly increase the risk of appearance of the disease, other negative factors - breakthrough of lung abscess, infective endocarditis, immunosuppressive therapy.
Radiation injury occurs under the influence of external radiation, and the degree of damage depends on the distance of the source of radiation.
Select all the reasons you can in groups:
- infectious;
- is a tumor;
- is allergic;
- radiation;
- is traumatic.
Any cancerous processes with metastases to adjoining organs( mammary glands, lungs) cause cardiac arrhythmias. The process can be caused by in the thoracic region, extensive myocardial infarction and chronic autoimmune and allergic processes of ( protective malfunctions - the body begins to damage its own tissues).
In children, the symptomatology is manifested after the acute - streptococcal and meningococcal - inflammatory diseases.
Health hazard and consequences
The danger of the disease lies in the inhibition of the main body - the heart , whose pumping function is significantly depressed. The effusion captures the adjacent organs and provides a persistent decrease in physical abilities.
Possible development of suppuration and the formation of cicatricial adhesions with the transition of pericarditis to an adhesive form requiring surgical treatment. Pericarditis, caused by tuberculosis, is extremely dangerous: mortality from an advanced illness is approaching 85%.Death occurs because of cardiac arrest.
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Symptoms and signs
The development of the disease does not pass asymptomatically - the patient begins to worry unpleasant sensations in the heart. The first "bell" is a feeling of heaviness, amplified by weak aching, dull pains.
What a person feels:
- pressing and bursting pains in the heart;
- increasing with every day shortness of breath;
- distortion of swallowing functions;
- rise in temperature to 38 degrees;
- appearance of hiccups;
- cold sweat.
The barking cough is another indication of the presence of pericarditis caused by compression of the trachea due to increased pericardial tissue. The natural process of blood circulation is also violated, the result is swelling of the face, neck, chest and legs.
The intensity of pain sensation depends on the amount of fluid - exudate.
Diagnostic procedures and first aid
Treatment of the patient begins with the study of the characteristic symptoms, if coincidence should immediately make an appointment with a cardiologist. The visual sign of exudate pericarditis is bulging of the thoracic wall( anterior) and cervical veins .To confirm the diagnosis, the doctor prescribes a series of studies:
- ECG
- ECHOkg
- chest x-ray
- biopsy and pericardial puncture
- tomography
Heart examination helps determine the type of pericarditis based on the dynamics and characteristics of cardiac murmurs. In the exudative form, can be traced back to blank deafness without the friction element .
The X-ray diffraction pattern of the displays an image of altered heart configurations: an increase in fluid accumulation warps the heart contour, giving the heart more roundness, and the shadow of the bundle of vessels on the x-ray is shortened.
There is also a general increase in the boundaries of the heart.
The patient is transported in a semi-sitting or sitting position( for the purpose of breathing).Removal of negative conditions in the heart is made by cardiac agents( cardiomin, corazole, camphor), in the lungs - respiratory inhalers( codeine, dionine, pyramidone).
Tactics of treatment
Rid of seizures of exudative pericarditis and its treatment is carried out under the supervision of doctors in the hospital. Monitoring includes recording the dynamics of changes in heart rate, blood pressure, CVP. The patient complies with bed rest and takes a course of medicines, which includes:
- antibiotics;
- diuretics;
- antihistamines;
- hormones.
Physiotherapeutic procedures do not show for this disease because of the risk of increasing proliferative processes.
In the presence of an infectious process, antibacterial therapy is prescribed( antibiotics of the cephalosporin group), including amoxyl or vancomycin .Ineffective treatment leads to a change in tactics - antibiotics of aminoglycosides are prescribed.
TB patients are prescribed streptomycin with the introduction of curative substances through the catheter( in severe situations).Fungal lesions require the use of flucytosine and amphotericin in the form of a dropper or intravenously.
The mild forms of inflammation are treated with with diuretics( furosemide) , but the action of diuretics is difficult in the presence of diseases of the urinary system. After removal of the inflammation, non-hormonal drugs are prescribed - ibuprofen and aspirin .The dosage of all agents is determined by the amount of exudate.
Large fluid accumulations - more than 200-300 ml - will require puncture and removal of effusion .Evacuation of the fluid is made by puncturing 2-3 cm with a needle under local anesthesia( novocaine) in certain areas of the sternum.
After puncture, the fluid leaves by gravity or aspirated by a syringe, then the collected liquid is sent to a laboratory test.
Purulent liquid is subject to sanation - the cavity of the bag is washed with an antiseptic solution, and in the progressing cases of it is possible to install a permanent catheter to remove the fluid.
An untreated effusive pericarditis passes into the chronic form ( fluid accumulation lasts more than 6 months), corrected exclusively by surgical intervention. Surgery involves excising part of the heart bag in areas without nerves and vessels.
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Prevention
Pericardial problems cause life-threatening conditions. To minimize risks, experts advise:
- to timely treat viral and infectious diseases;
- to avoid sternum injuries;
- treat myocardial complications;
- use radiation protection;
- treat cancer complications.
Prospects for treatment and the condition of the patient
Patients who undergo surgery or treatment are advised to restrict physical and mental stress, reduce salt intake, and carry out annual flu vaccination. Among the rehabilitation activities equally equally are resort and sanatorium treatment, frequent rest and dietary meals.
The danger is represented by surgical intervention : lethality during pericardectomy varies from 5 to 12% and depends on the presence of unrecognized myocardial fibrosis before the operation.
Exudative forms without complications demonstrate a positive dynamics of treatment and the patient's return to normal life. In 30% of cases with the spread of inflammation on the myocardium atrial arrhythmia and tachycardia is formed. Overall prognosis moderately unfavorable to , especially when delaying therapeutic treatment.
