Inflammation can
occur anywhere in the body. We have all
had that really sore wrist after rewriting physiology notes or really sore throat
during flu season but hopefully these minor inflammatory responses don’t last
very long. In fact these inflammatory
responses are beneficial in that they help get rid of pathogens and repair
injury (Kumar et al., 2004). However, sometimes too much inflammation can be
harmful and depending on the area of the inflammation, it can be deadly if not
treated aggressively.
Pericarditis is
an inflammatory process within the sac that holds your heart in place called
the pericardium. This inflammation can
arise with fluid build up within the pericardium as a result of many other
possible pathological origins (Aehlert, 2012, p.263). Although pericarditis is rare it is even more
interesting that 90% of pericarditis cases are of viral or unknown cause (Aehler,
2012, p.263-264). Due to the composition of the pericardium, it important to
keep appropriate fluid volume within this enclosed space. The pericardium is composed of two layers.
One called the fibrous pericardium, the outer layer that is tough and limits over
dilation of the heart. The inner layer
called serous pericardium allows for just enough expansion of the heart for
appropriate contraction (Moore et al., 2014, p.128).
So why is this
important? I would say because out of all of the places to get infections and
injuries, it would be the most ideal not to have it near your heart. What are some indications of pericarditis, you
ask? Pericarditis can cause pain, more specifically pinpoint pain that is
unlike generalized chest pain typically seen in myocardial infarcts. Since the heart lies in this sac it is also
important to note abnormal cardiac sounds such a pericardial friction rub with
a stethoscope. This friction rub is a
classic sign of pericarditis (Aehler, 2012, p.263). More related to physiology
lab, the biggest indicators of pericarditis are EKG changes. The
most noticeable change is widespread elevation of the ST segment of the cardiac
rhythm. Unlike myocardial infarctions,
in which ST elevation is noted in certain areas of the heart where the damage
is located, ST elevation is noted on all views of the heart when using a 12
lead EKG.
Patients are
typically treated with NSAIDs depending on stage of inflammation and finding the root
cause of pericarditis remains priority in order to prevent further inflammation
and recurrent symptoms.
Aehler, B.
(2012). ACLS study guide. St. Louis,
MO: Elsevier. 263-264.
Kumar, R.,
Clermont, G., Vodovotz, Y., & Show, C. C. (2004). The dynamics of acute
inflammation. Journal
of Theoretical Biology. 230(2). 145-155.doi:10.1016/j.jtbi.2004.04.044
Moore, K. L.,
Agur, A. M., & Dalley, A. F. (2018).
Clinically oriented anatomy. Philadelphia: Wolters Kluwer. 128.
Nice post! Your talk of inflammatory responses definitely reminded me of cortisol and stress levels that we talked about during TBL 1 when we discussed how some is beneficial but too much for too long can be harmful. It is all about moderation when it comes to our bodies and maintaining homeostasis.
ReplyDeleteYour post also got me thinking about heart cancers and why it is so rare. We definitely don’t want infections or injuries anywhere near our hearts but at least we don’t really have to worry about getting cancer there since cardiac cells are amitotic. Another bout of good news is that pericarditis is sort of rare since there are fewer than 200,000 cases per year in the US and that it usually goes away relatively quickly. I believe the problem here would be if the patient with pericarditis has additional ailments that could potentially be made worse by the pericarditis.
I wonder if pericardiocentesis/pericardial tap is every used for pericarditis if it is severe since it’s a way to remove fluid from the sac if pressure is too high and it allows for the fluid to be tested for infections and such.
Sources:
Health.ClevelandClinic.org
Mayo Clinic
WebMD
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