Pericardial Disease

Pericarditis is a common condition in which there is inflammation of the pericardium, the thin membrane surrounding the heart. There is normally a small amount of fluid between the inner and outer layers of the pericardium. When the pericardium becomes inflamed, the amount of fluid between its two layers often increases. If the amount of fluid is large, or accumulates quickly, this can impair the ability of the heart to fill and function properly.

The most common type of pericarditis affects young individuals, often between the ages of 20-50. The disease is sometimes mild and requires little treatment, but it also can lead to life-threatening complications.

The key point for patients and medical specialists is that pericardial disease outcomes are good when the condition is recognized and treated early and appropriately. Cardiovascular specialists at the Brigham and Women’s Hospital (BWH) Heart & Vascular Center offer comprehensive inpatient and outpatient clinical services to adults with pericardial disease, from diagnosis to medical, interventional and surgical treatments.

Pericardial Disease Topics

Risk Factors for Pericardial Disease

The cause of pericardial disease is most often a viral infection. Other causes include:

  • Bacterial or fungal infections
  • Autoimmune disorders, including lupus and rheumatoid arthritis
  • Inflammation following a heart attack or after cardiac surgery
  • Chest trauma or injury
  • Cancer
  • Tuberculosis
  • Kidney failure
  • Radiation therapy
  • Certain medications
Symptoms of Pericardial Disease

The most common symptoms of pericardial disease include:

  • Chest pain – Sharp pain felt behind the breastbone or left side of the chest. It may be accompanied by neck, shoulder, back or abdomen pain. Lying flat, coughing, and deep breathing can increase pain. Sitting up or leaning forward can relieve pain.
  • Fever
  • Shortness of breath
Diagnosis of Pericardial Disease

At Brigham and Women’s Hospital, our cardiovascular specialists provide expert evaluation and diagnosis with the aid of the latest in advanced imaging technologies. Along with performing a careful physical examination, your cardiologist may order one or more of the following tests or procedures:

Treatment for Pericardial Disease

Our cardiovascular specialists develop individualized treatment plans for patients based on:

  • Age
  • Overall health
  • Medical history
  • Severity and form of the disease
  • Tolerance for specific medications or procedures
  • Expectations for course of the disease
  • Presence of other conditions

Treatment may include:

Medication

Interventional Procedures

  • Pericardiocentesis An interventional cardiologist guides a needle through the chest and into the pericardium. Excess fluid is then removed via a catheter.
  • Balloon Pericardiotomy A tiny balloon at the end of a catheter is used to create a drainage hole in the pericardium.

Surgery

  • pericardiectomy may be performed to treat chronic or recurring pericarditis. This procedure involves removing part or all of the pericardium.
What You Should Expect

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Watkins Clinic for pre-operative information and tests.

The day of surgery, you care will be provided by physicians, anesthesiologists and nurses who specialize in surgery for patients with pericardial disease. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

During your surgery, family and friends can wait in the Shapiro Family Center. Staff members will provide surgery updates and caregivers who leave the hospital will be contacted by cell phone.

Multidisciplinary Care

Patients benefit from the teamwork of medical cardiologists, interventional cardiologists, cardiac surgeons, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in pericardial disease. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.

Resources

Learn more about pericarditis in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center where patients and families can access computers and knowledgeable staff.

Access a complete directory of patient and family services.

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