Pericarditis
Published April 17, 2024 | 
(1997)
The heart is surrounded by a membranous sac called the pericardium (meaning “around the heart”).
As is true of most body cavities including our joints, the surfaces of the pericardium and heart are lubricated by a small amount of fluid. If excessive fluid accumulates, it’s called a pericardial effusion. There are many causes of excessive pericardial fluid, but it’s most commonly related to a viral infection. Less common causes include inflammatory disease (such as lupus), cancer that has spread to the pericardium, kidney failure with uremia and tuberculous pericarditis.
If the fluid increases at a very slow rate, the pericardium may stretch to accommodate the fluid and not cause symptoms until the amount becomes quite large. Rapid accumulation, on the other hand, can limit the heart’s ability to fill between beats (cardiac tamponade) and may be an immediate threat to life. Treatment of pericarditis depends upon the cause and whether heart function is impaired. Most viral pericarditis resolves spontaneously over several weeks, although recurrences are possible. If bacterial infection is the cause, antibiotics may be effective. If the fluid is limiting the heart’s function, it may be necessary to remove it with a needle and syringe. Rarely, surgical treatment may be required.