Inflammatory Cardiac Disorder ( Pericarditis)

Pericarditis

Pericarditis is the pericardium's inflammation. It could be acute or ongoing. The condition known as chronic pericarditis causes the pericardium to thicken and become inflamed over time, compressing the heart. In a healthy state, the pericardial fluid maintains the layers' separation to prevent friction. In pericarditis, the layers of the sac swell up and may rub on the heart. It could feel like heart attack pain.

Causes

• Infection:
  • Viral-coxsackie, influenza
  • Fungal, parasite
  • Bacterial: tuberculosis, staphylococcus, streptococcus, meningococcus, pneumococcus
• Myocardial Injury: MI, trauma, post cardiac surgery, pace maker implantation
• Collagen disease: Rheumatic fever, scleroderma, SLE, Rh arthritis
• Drug reaction-procainamide, doxorubicin HCL etc
• Uremia
• Neoplasm
• Radiation therapy

Pathophysiology

Causative factor (present)

               ↓

Inflammatory process start Increased capillary permeability

               ↓

Allowing pericardium-bound plasma proteins, such as fibrinogen, to leave capillaries

                 ↓

Pericarditis

                ↓

Exudates formation

              ↓

Fibrosis, serous/hemorrhagic effusion

• Fibrous exudates: which is described as having a shaggy bread and butter appearance because it looks like the surface of a pulled-apart bread and butter sandwich.
• The pericardial sac is inflamed: Cardiac tamponade or heart failure may result from loss of pericardial elasticity or an accumulation of fluid within the sac.
• Acute Fibrinous pericarditis: The fibrin strands may reorganize, scar tissue may be deposited, and adhesion between the layers of the serous pericardium may form as a method of healing.

Signs and Symptoms

• Radiating pericardial pain to the left side of the neck, shoulder, or back from the anterior chest
• Pain that is made worse by breathing (particularly inspiration) sneezing and coughing
• Rub of pericardial friction (scratchy, high pitched sound)
• Leaning forward can ease pain, which is worse when lying flat.
• Malaise and exhaustion
• Chills and a fever
• ECG changes include a reduction in the complex's amplitude, an increase in the ST segment, and bradycardia or atrial fibrillation on the T wave.
• High WBC and ESR
• Right ventricular failure symptoms in a patient with chronic constrictive pericarditis

Diagnosis

• ESR, WBC, ASo titre, Rh fever, uremia, BUN, cardiac enzyme, high in the lab Test of a live function
• Detection of acute pericarditis by chest X-ray
• Catheterization of the heart
• ECG, echocardiogram

Management

• To treat pain, use analgesics, NSAIDS, or corticosteroids.
• Pericardiectomy, if necessary
• To treat underlying infections with antibiotics
• Chronic constrictive pericarditis caused by diuretics and digoxin
• Cardiac surveillance
• 02 Treatment and rest in bed

Nursing Interver

• Maintain a calm atmosphere to aid the patient in getting the most rest possible. If necessary, use painkillers.
• Give prescription drugs as directed.
• Analyze the type of pain.
• Check your chest for pericardial friction rubs.
• Review blood culture findings to find the culprit organism.
• Keep an eye out for symptoms such as pulsus paradoxus, muffled heart sounds, narrowing p pressure, tachycardia, and decreased cardiac output.
• In case of cardiac tamponade, call the doctor.
• If surgery is performed, make the necessary arrangements.
• Patient education: Modification of lifestyle. Treat and monitor