Overview

Pericardial Disease

The heart is enclosed in a membrane called the pericardium. The pericardium, or the pericardial sac, is a thin, double-layered sac that protects the heart. It has a small amount of fluid that provides lubrication for the heart.

The Northwestern Medicine clinical team offers rare, highly specialized clinical expertise for the treatment of pericardial disease. Our multidisciplinary team is uniquely qualified to care for the complexities associated with pericardial disease. This expertise includes leading-edge diagnostic testing as well as advanced medical and surgical treatment options.

Pericardial disease includes several diagnoses, including:

• Pericarditis
• Pericardial effusion
• Pericardial tamponade
• Constrictive pericarditis
• Pericardial cysts

Pericarditis

Inflammation anywhere in the body occurs when the immune system sends out cells to heal an injury or to protect the body from infection. Pericarditis is an inflammation of the pericardium. Inflammation of the pericardium leads to swelling and irritation. This can cause chest pain.

Myocarditis occurs when the inflammation involves the muscle of the heart.

Types of pericarditis:

Acute pericarditis begins suddenly and may last a few weeks. Future episodes may occur.

• Among those treated for acute pericarditis, up to 30% may have it again in the future.
• A small number of people can eventually develop chronic or recurrent pericarditis.

Incessant pericarditis lasts about four to six weeks but less than three months with continuous symptoms.

Recurrent pericarditis is a recurrence of pericarditis after the first episode, with a period of about four to six weeks with no symptoms between the episodes.

Chronic pericarditis usually lasts longer than three months.

Pericardial Effusion

Pericarditis can lead to a buildup of excess fluid between the walls of the pericardium. This is called pericardial effusion.

Pericardial effusion can be managed with medication. In some cases, the pericardial effusion will need to be drained. This procedure is called a pericardiocentesis.

Pericardial Tamponade

Pericardial effusion can cause a life-threatening situation called pericardial tamponade.

Pericardial tamponade occurs as the excess fluid from the pericardial effusion continues to build. This puts pressure on the heart that keeps the heart from filling properly with blood. Patients need emergency treatment to release the pressure on the heart. The procedure to drain the pericardial tamponade is called a pericardiocentesis.

Constrictive Pericarditis

A small number of patients can develop constrictive pericarditis.

A healthy pericardium is flexible. In constrictive pericarditis, the pericardium becomes stiff and thick. This limits the pumping function of the heart, leading to fluid buildup in the body.

If found early, treatment with anti-inflammatory medication can reverse constrictive pericarditis. However, patients with constrictive pericarditis may need surgery called a pericardiectomy.

Pericardial Cysts

Pericardial cysts are growths filled with fluid that appear in the pericardium. These cysts are usually congenital, meaning you are born with the cyst. The cyst can be treated by draining it or removing it through surgery.