12
issue: heart
The HEALTH | NOVEMBER, 2018
MAYO CLINIC
A heart with pericarditis and a
normal heart.
Pericarditis
An inflammation of
the membrane covering
the heart
P
ERICARDITIS is the
inflammation of the peri-
cardium which is a thin
membrane which covers
the heart.
Sri Kota Specialist
Medical Centre Con-
sultant Cardiologist Dr G.S. Sridhar
revealed that there are numerous causes
for the inflammation.
“It usually occurs in the younger
age group (20 – 30’s) and especially in
females which is due to infection, viral
infection and tuberculosis. Sometimes,
patients with kidney failure who has
more urea in the blood could also result
in pericarditis.”
“Pericarditis usually lasts from a few
days until three weeks by definition. But
anything that last more than three weeks
to three months is known as incessant.
Anything more than three months is
called as chronic pericarditis.”
Symptoms
“Patients who have pericarditis, they
Dr G.S. Sridhar.
present with very short pricking pain
in the centre of the chest which can be
worst during inspiration and could also
be worst when they lay down flat. When
they sit up, they would feel better.”
Diagnosis
“We would do a clinical examination,
supported by a blood test and an imag-
ing. Clinical examination is the way a
patient presents the disease. When we
hear the heart sound – we would hear a
friction rub. When there is an inflamma-
tion, there will be a mild fluid collection
Coronary vasospasm
PEOPLE without fixed, severe coro-
nary blockages can have chest pain due
to a rare condition called coronary
vas0spasm.
Sri Kota Specialist Medical Centre
Consultant Cardiologist Dr G.S. Sridhar
revealed that this spasm refers to the
constriction of the blood vessel.
Cause
Most of the time, the cause for coronary
vasospasm is unknown. In addition to
that, other common causes is the usage
of tobacco and cocaine.
Symptoms
“In a muscle spasm, they would present
with a classical angina like symptom.
“Patients who
have pericarditis,
they present
with very short
pricking pain in
the centre of the
chest which can
be worst during
inspiration and
could also be
worst when they
lay down flat.
When they sit up,
they would feel
better.”
in between the sack and the heart which
actually cause a pericardial rub.”
“When we do an ECG, there will be
a concave kind of ST-elevations and
when we do an echocardiography (an
ultrasound of the heart) there would be
the sound of fluid collection. In addition
to that, an MRI of the heart also picks-up
the condition which might have a little
late uptake of the contrast when we
inject.”
Treatment
“Treatment is based on the underly-
ing cause – if it is due to the infection,
than that has to be treated with an
appropriate anti-viral antibiotics. In
majority of the cases, we might be able
to find the exact cause. So, the main
treatment may be painkillers (Non-
steroidal Anti-Inflammatory Drugs
(NSAID) such as ibuprofen or a high
dose of aspirin.”
Acute Pericarditis
Usually, in acute pericarditis, there
would be very severe pain compared
to chronic pericarditis which is not as
severe.
“Most of the time in chronic pericar-
ditis, we would know the underlying
cause which is the main thing that we
would need to treat.”
“Patients with kidney failure and
other connective tissue disorders like
Systemic lupus erythematosus (SLE)
are more susceptible to get chronic
pericarditis.”
MAYO CLINIC
Patients would have a heart attack, they
would have a left sided chest pain, the
pain would go to the left arm, it would go
to the back, and there might be numbness
of the arm, jaw and profuse sweating.”
Diagnosis
“The only way to diagnose is to do a
coronary angiogram. When we do an
angiogram, there would be a constriction
of the blood vessel.
“In the past, Prinzemetal’s angina
where there is no plaque or significant
livery, there is constriction of the blood
vessel. Medication which relaxes the
blood vessel is given as treatment. It is
not a blood thinner, but a medication that
relaxes the blood vessel.”
The illustration
shows a coronary
artery spasm.