Image source: Pixabay
Do you or a loved one suffer from heart failure symptoms? If so, you should consider getting tested for constrictive pericarditis. While this disease is relatively uncommon, it does affect a growing segment of the population. If you think the condition applies to you, then let us take a closer look at what the exactly it entails.
Constrictive Pericarditis: Symptoms, Causes, & Treatment
When left untreated, constrictive pericarditis is a potentially life-threatening disease. However, if it the doctor diagnoses it early on, individuals who suffer from the circulatory illness can lead a healthy life. But in order for a medical professional’s diagnostic, you must first recognize the symptoms and understand the disease. In this article, we will give you a general summary of the disease itself and the potential treatment options you should consider.
What is Constrictive Pericarditis?
Video by: Manipal Hospitals
Constrictive pericarditis is a chronic inflammation that occurs in the pericardium. The pericardium is a thin sac that encloses the heart. During this form of clinical heart failure, the pericardium sac becomes thickened through scarring. During regular pericarditis, this sac can become inflamed which leads to chest pains. If left untreated this condition can develop into constrictive pericarditis — a much more severe, often life-threatening heart condition.
Constrictive pericarditis is a rare form of heart disease, and it only affects .05% of cases according to the American College of Cardiology. However, there is a potentially reversible form of surgery treatment, so it is vital to diagnose the disease when it does occur.
What Are the Symptoms of Constrictive Pericarditis?
When the pericarditis becomes firm and immovable, it does not allow the heart to expand to its fullest extent. Thus the heart cannot correctly fill up with blood to pump when it contracts. As such, the symptoms associated with constrictive pericarditis are similar in appearance to the main other heart failure condition. Similarly, it is vital to have any signs checked out as soon as they occur since timeliness is an essential factor.
What Are the Causes of Constrictive Pericarditis?
The cause of constrictive pericarditis is not always readily available or knowable. It is a very slippery condition. In some cases, the medical practitioner may not even be able to find out the exact cause of the situation. Luckily, this knowledge is not particularly necessary for treatment. Even if you do not know the cause of your constrictive pericarditis, you can still treat it.
The most common identifiable causes found in people with the condition is a history of previous cardiac surgery, exposure to intense chest radiation, and tuberculosis. However, doctors also believe that the disease could be caused by rampant viral infections, bacterial infections or mesothelioma — an aggressive form of cancer often associated with asbestos poisoning.
Certain individuals are more susceptible to the disease than others. Trauma to the heart is a significant factor, whether it is a past heart attack or previous heart surgery. If you ever suffered from autoimmune conditions like Systemic lupus or rheumatoid arthritis, then you are more likely to have constrictive pericarditis.
Similarly, individuals with regular pericarditis often face development into a chronic condition. The condition remains a potential side effect in some medications, so if you are susceptible to heart disease, make sure to fully explore the side effects of any medication you are taking. Gender and age appear to be the more general causes — constrictive pericarditis happens mostly to men between the ages of twenty and fifty.
How Do I Determine if I Have Constrictive Pericarditis?
Video by: Cleveland Clinic
Diagnosing constrictive pericarditis is by no means a simple task. Constrictive pericarditis bears such a distinct resemblance to other forms of heart failure like the cardiac tamponade and restrictive cardiomyopathy; they are often tough to distinguish. Both of these conditions both exert intense pressure on the heart via the pericarditis, so it is widespread for some individuals to confuse these conditions mistakenly.
Unfortunately, the mortality rate for individuals with constrictive pericarditis is incredibly high when left untreated — especially in the later stages of the disease — so finding the correct diagnostic often does mean the difference between life and death.
The most successful test in determining whether or not an individual has constrictive pericarditis is a detailed inspection of the jugular venous pressure. Often the burden placed on the right side of the heart is so high, that the jugular venous pressure becomes inspectable in the brain of the patient. Individuals with constrictive pericarditis often have a 93% increase in their jugular venous pressure when they sit up, so this can be very helpful when narrowing the parameters of the disease.
If the jugular venous pressure is observable via a physical exam, then the condition may be diagnosable without further tests. This diagnoses is particularly accurate if the physician observes Kussmaul’s sign —resulting from the jugular venous pressure — and hears a pericardial knock. Other telling exterior signs include bulging neck veins, faint sounds of the heart beating, intense swelling around the liver, and fluid in the belly.
However, more often than not, further detailed testing must take place before a doctor can reach an official diagnostic. A chest x-ray may help identify calcification occurring in the pericardial region and a buildup of fluid between the chest cavity and the lungs. Echocardiography is another method which uses echoes to create a sonogram of the heart. This sonogram may help identify the volume of blood in specific sections of the heart when it fills up.
Similar to an x-ray, an MRI scan or a CT scan both produce detailed images of the heart and its surrounding areas. Often these scans are used to identify dangerous blood clots and a general thickening of the pericardial sac. In some cases, cardiac catheterization is necessary. In these circumstances, a doctor inserts a catheter with a camera into the patient’s heart chamber or vessel for diagnostic purposes.
Alternatively, a BNP blood test may be performed to distinguish constrictive pericarditis from restrictive cardiomyopathy. As we mentioned before, restrictive cardiomyopathy is nearly identical to many cases of CP. BNP is the distinguishing factor. BNP, or brain natriuretic peptide, is found in cases of restrictive cardiomyopathy but not with constrictive pericarditis.
Treatment Options for Constrictive Pericarditis
Video by: Healthy times
The best-known way to deal with constrictive pericarditis is through surgery. This surgery is known as a pericardiectomy or pericardial stripping. This surgery can be potentially dangerous, but it is the only known definitive cure. During pericardial stripping, a surgeon opens up the patient’s chest, removes the infected pericardium, re-covers it and then closes up the chest cavity. The surgery is often much more successful if it is performed early on in the diagnostic process before severe calcification occurs.
While there are some non-surgery related methods for slowing the disease, these treatments are not useful in the long run. Unfortunately, pericardial stripping is not a viable option for many patients. If someone is in the advanced stages of the disease, then a pericardiectomy will often provide no relief. Similarly, if the cause of someone’s constrictive pericarditis is radiation, a pericardiectomy has been shown not to assist. The procedure has a 6% mortality rate amongst patients with constrictive pericarditis.
However, there are steps you can take to reduce the symptoms until you can deal with it. The first way to prep is through the use of diuretics. Diuretics force the body to rid itself of excess water through urination. Flushing the system of its excess fluids helps relieve pressure and congestion placed on the heart. However, diuretics should be taken under a doctor’s recommendation.
In some cases, specific steroid combination has been useful in fighting the condition if they used before the development of pericardial fibrosis. Similarly, if the cause of the chronic condition is an autoimmune disease like tuberculosis, then any medications that treat the underlying condition should be beneficial in slowing the spread of the disease (like antituberculosis medication). Pain medication and anti-inflammatory medication like Advil can help reduce some of the symptoms of the condition.
Constrictive pericarditis is undoubtedly a scary heart condition when compared to other cardiovascular diseases — especially since the treatment options are so limited. It is often misdiagnosed, or never diagnosed at all. But the technology and procedures of modern medicine make some form of treatment viable, especially if the disease doctors catch the condition early. Because the condition affects such a slim margin of the population, it is often the first thing that is overlooked by some healthcare professionals.
Often this treatment requires both intense activism and research on not only the doctor’s but also patient’s accord as well. If you suspect that you suffer from constrictive pericarditis or any other heart condition, it is vital that you schedule a consultation with a cardiologist today. We hope this article was helpful in providing information about this cardiovascular condition.