Pericardium: photo, structure, function, disease, treatment. Pericardium is ...

How often we hear that someone has a sick heart, but rarely understand what is at stake. Diseases associated with the cardiovascular system, many. And they all abound in incomprehensible definitions and terms. Here, for example, pericardium. What is it, where is it located and what does it suffer from?

What is the pericardium?

First of all, it is necessary to understand what is at stake. Pericardium is a pericardial sac, which contains not only the heart, but also the pericardial vessels. The word came into medicine from the Greek language. Its literal meaning is "around the heart". Some doctors call the pericardium a near-hearted shirt. In fact, it is the outer shell of the heart from the connective tissue.

In its structure, the pericardium is a closed bag resembling a truncated cone. In an adult, its narrow base lies on the diaphragm, the wide apex rests on the ascending aorta. The entire bag consists of two sheets, one of which is parietal, it is called the pericardium. The second is visceral, that is, epicardium.

The structure of the pericardium is compound. There are two layers: the serous inner and fibrous outer. The fibrous layer consists of a dense fibrous tissue covering the heart and passing into the pulmonary trunk and the mouth of the pulmonary veins. The serous layer consists of a dense connective tissue covered with a flat epithelium. In serous tissue, a specific fluid is produced that fills the gap between the pericardial and epicardial sheets. It is a natural lubricant that facilitates friction. In a healthy pericardial adult bag contains about 25 ml of liquid. Thus, the structure of the pericardium is due to the maintenance of tissue pressure and the exercise of a supporting function that prevents excessive stretching of the heart. Lubricating sheet fluid reduces friction when cutting the organ.

Pericarditis. Definition

Violation of the structure or functioning of the pericardium is called pericarditis. This is an inflammatory process that occurs in the tissues of the pericardial sac. Since the pericardium is an important component of a healthy cardiovascular system, any pathological processes are dangerous for humans.

Because of inflammation inside the cavity, there is accumulation of liquid exudate. This leads to a squeezing of the heart, which complicates the normal pumping of blood. The structure of exudate is of two types. It can be purulent or serous, depending on the nature of the pericardial lesion.

The main problem of patients is that the disease is difficult to diagnose. In heart diseases, doctors establish this diagnosis only in 0.5% of cases. However, according to statistics, up to 5% of the cores die from pericarditis. More than 80% of cases are diagnosed after autopsy.

Medical classification

Pericarditis is divided into three main groups. Pericardial diseases can be contagious, aseptic or idiopathic.

The cause of infectious pericarditis can be tuberculosis, gonorrhea, syphilis, dysentery. Less common bacterial lesions are also considered, such as cholera, typhoid and anthrax.

Manifestations of aseptic pericarditis are characteristic for rheumatic diseases, myocardial infarction and aortic aneurysm. Also, the cause may be injuries and surgery. Oddly enough this sounds, but a similar pathology can be caused by non-cardiac diseases, such as pneumonia, perforation of the esophagus and others. Aseptic diseases of the pericardium can accompany blood cancer and malignant tumors in other organs. Sometimes an allergy, medication or radiation therapy is the trigger.

Idiopathic pericarditis has an unclear genesis. The cause of the problem can not be clarified.

Development of pericarditis (infectious form)

The easiest way to identify pericarditis, which developed against the background of an infectious disease. In this case, the immune processes in the body are triggered to fight the bacteria. The effect of pathogens on tissues and organs increases the permeability of vascular membranes. A liquid saturated with components of blood coagulation penetrates the pericardium. This changes the composition of the lubricating fluid in the bag cavity, disrupts the structure of the pericardial tissue, turning it into scar tissue. The first stage of the disease is dry pericarditis. The second stage is adhesive, in which there are adhesions and scars.

Symptoms of the first stage

When referring to a doctor, patients with dry pericarditis complain of pain in the heart. Painful sensations have their own peculiarities:

1. From the moment of occurrence within several hours the pain grows. The nature and intensity of the pain from the weak approaches the intolerable. It can be described as stitching, burning or pressing.
2. Painful sensations arise behind the sternum, in the region of the left armpit, in the epigastrium. They give in the neck or the right hypochondrium and abdomen.
3. Pain increases with deep breathing, an attempt to swallow saliva or food, coughing, and movement.
4. The pain decreases if you lean forward or lie on your right side and press your bent legs.

Indicative is that the pain does not respond to the "Nitroglycerin", but decreases from pain medications.

Exudative form

As the pericardial disease develops, liquid or pus begins to accumulate inside the pericardium. At this stage, there is chills, shortness of breath, dry cough, chest tightness, hiccough, cyanosis and puffiness.

Treatment

Depending on the form and course of the disease, patients are prescribed analgesics, anti-inflammatory drugs and supportive agents. Also shown are preparations of magnesium and potassium.

When purulent processes are added antibiotics of a different mode of administration. This may be oral, intravenous or catheter pericardial. Purulent exudate requires removal.

In some cases, a pericardial puncture is prescribed. In the adhesive process, heart surgery is necessary.