The pericardium is a sac-like structure that surrounds the heart. Inflammation of the heart sac, called pericarditis, can be due to infections caused by various types of bacteria or viruses.
What is going on in the body?
In most cases, a person with this disease starts out having an infection, such as pneumonia, somewhere else in the body. The bacteria can then get into the bloodstream and reach the heart. Infection of the heart sac results in bacterial pericarditis, which is life threatening.
What are the causes and risks of the disease?
Several different bacteria can cause this disease. Examples include staphylococci, group A streptococci, and the bacteria that cause Lyme disease.
The risks of this disease include:
- cardiac tamponade, a condition in which too much fluid accumulates around the heart. This causes the heart to collapse, making it unable to pump blood.
- constrictive pericarditis, a condition in which the heart sac gets stiff and reduces blood flow into and out of the heart
- formation of a pocket of pus, called an abscess, in or around the heart
- spread of the infection to other areas of the body
What can be done to prevent the disease?
Early treatment of certain infections, such as pneumonia, with antibiotics may prevent some cases. Many cases cannot be prevented.
How is the disease diagnosed?
A healthcare professional may suspect this disease after taking a person's health history and doing a physical exam. An ECG, or electrocardiogram, and chest x-ray may show certain changes.
Heart function and fluid accumulating around the heart can be seen by a special x-ray test. This test, called echocardiography, uses ultrasound waves to get an image of the beating heart.
Some of the fluid around the heart may be removed with a needle inserted through the chest. This fluid can be sent to the lab for analysis. This allows the bacteria causing the infection to be identified so that the right antibiotic can be used. Blood is usually sent to the lab for testing as well, as it also often contains the bacteria.
Long Term Effects
What are the long-term effects of the disease?
Most people recover with treatment . However, some people develop a stiff heart sac after recovery. A person with this complication often needs surgery. Death can occur in more severe cases.
What are the risks to others?
This condition is not contagious. However, the infection that led to this disease, such as pneumonia, may be contagious.
What are the treatments for the disease?
Antibiotics are usually the most important part of treatment. Medications to relieve pain and reduce inflammation can help relieve some of the symptoms, such as chest pain. If fluid builds up and compresses the heart, a needle may need to be placed through the chest and into the space around the heart to drain the fluid. If the heart sac becomes stiff, surgery to remove the heart sac may be needed.
What are the side effects of the treatments?
All medications have possible side effects. For instance, antibiotics may cause allergic reactions and stomach upset. Surgery may result in bleeding, infection, and even death.
What happens after treatment for the disease?
Most people respond well to antibiotic treatment and can return to normal activities within a few months. Even those who need surgery usually have a full recovery.
How is the disease monitored?
Regular office visits and repeat echocardiogram tests are used for monitoring. A return of symptoms may represent progressive disease or the development of a stiff heart sac. Any new or worsening symptoms should be reported to the healthcare professional.
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Merck Manual, 1999
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Heart Disease: A Textbook of Cardiovascular Medicine. Braunwald, 1980