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Pericarditis. What it is and aiding recovery

Heart, Immune | June 3, 2020 | Author: Naturopath

Immune, Heart Attack, heart, autoimmune

Pericarditis. What it is and aiding recovery

The pericardium is a two layered sac-like membrane which surrounds the heart. Pericarditis is inflammation of the pericardium. Inflammation causes swelling, irritation and pain, resembling a heart attack and may cause anxiety and fear in sufferers. Although pericarditis can be a symptom of heart attack, it is most often due to a viral infection. Pericrditis can be acute, sub-acute or chronic.

The Role of the Pericardium

The pericardium is a flexible membrane, consisting of two layers divided by fluid, which surrounds the heart. Peri – meaning “all around” and cardiac – pertaining to the heart. The slick fluid allows the layers to glide easily over each other.

The role of the pericardium is to:

  • protect the heart from being damaged by chest infection
  • prevent the heart from over-filling
  • hold the heart in position

Disorders of the pericardium can include congenital deformities - such as holes or missing pericardium, cancer and injury, heart attact, but the most common disorder is inflammation of the pericardium – pericarditis.

What is Pericarditis

Pericarditis is inflammation of the pericardium - often with accumulative fluid. It may be caused by infection, myocardial infarction (heart attack), trauma (injury), tumours, metabolic disorders, autoimmune disorders such as lupus, rheumatoid arthritis or sclerodema; kidney failure, or it may be idiopathic (no known cause).

What is Pericarditis

  • Viral infection is very common cause of pericarditis and will usually resolve on its own. Anti-inflammatory medication may help with symptoms. 
     
  • Bacterial pericarditis may occur from infection anywhere in the body. It is serious and may be fatal without prompt medical intervention. 
     
  • Myocardial infarction (heart attack) leads to the production of oxygen free radicals which cause damage to heart tissue and induce myocardial apoptosis (cell death) and inflammation. The result is scaring (fibrosis) and an increase in size (hypertrophy) of the surviving cells of the heart muscle with subsequent heart failure.

Constrictive pericarditis. The pericardial fluid becomes thick and fibrous and reduces the capacity of the layers to glide smoothly over one another causing them to stick together. Constrictive pericarditis may occur as scar tissue develops as a result of recovery from inflammation or injury. Scar tissue causes the pericardium to become stiff and hard and reduces the capacity of the heart to fill properly with blood. Symptoms of constrictive pericarditis include weight loss, fatigue, breathlessness, abdominal distention and a heart murmur.

Pericardial effusive. This occurs when there is too much fluid in the pericardial space reducing the capacity of the heart to fill with blood. This fluid may be blood, serous, pus, serosanguineous or chyle.

Cardiac tamponade is when the fluid builds up enough to effect the functioning of the heart.

Hemopericardium refers to blood in the pericardial space causing inflammation and scaring.

Uremic pericarditis due to kidney failure.

Symptoms of Pericarditis

  • Chest pain or a tightness which is worse upon deep breathing. Pain might resemble that of a heart attack and radiate from left shoulder down the left arm
  • Abnormal heart rhythms
  • Shortness of breath
  • Water retention
  • Swelling in lower legs and abdomen

Pathophysiology

  • Acute pericarditis. Development occurs quickly and causes inflammation and often fluid accumulation and occurs soon after a triggering illness such as a viral or bacterial infection. Acute can develop into sub-acute or chronic. Acute may occur from infection, inflammatory disorders, autoimmune, heart attack, trauma, cancer, radiation therapy of medication. A pericardial friction rub is highly specific for acute pericarditis. It is a sound heard by the medical professional at various times on examination, louder when breathing in and forward bending.
     
  • Sub-acute occurs a few months after a triggering illness or event.
     
  • Chronic inflammation lasts for 6 months or more. It is associated with hypothyroidism, tuberculosis or the reason may be unknown.

Complications of Pericarditis

Congenital defects – such as weak areas or holes which may lead to the heart or a major blood vessel bulging into the hole and requires surgical intervention. Serious complications can occur when the heart is compressed and cannot function correctly. Scar tissue and inflammation can restrict heart function. If there is a build-up of pus from an abscess within the heart or the pericardium. Infection can spread to other areas. Pericarditis can be life threatening if pericardial effusion and cardiac tamponade occur.

Medical Treatment for Pericarditis

Medical Treatment for PericarditisTreatment is based on cause and seriousness of the condition and may involve simply rest and pain-relieving medication, but may also involve antibiotic, diuretic, steroids, anti-inflammatory medication, and in some instances – surgery. Death of muscle cells (myocytes) due to in ischaemic myocardial infraction (lack of oxygen to the heart due to heart attack) can result in an intensive inflammatory response. Antibiotic therapy in the case of bacterial infection.

What can aid recovery from pericarditis

As pericarditis is most commonly a result of heart disease or infection, supporting the immune system and cardiovascular system is most important. Follow a good diet full of healthy, natural foods; Get plenty of quality sleep; Reduce stress and participate in an active lifestyle for best results. The following supplements have been studied for their health benefits following pericarditis.

Quercetin is a valuable flavonoid found in fruit and vegetables and supplement form which offers anti-inflammatory and antioxidant properties important in post-traumatic cardio myocytic apoptosis (heart muscle cell death) a contributing factor to cardiac dysfunction after trauma. Studies showed quercetin may reverse post-traumatic cardiac dysfunction by reducing cardiomyocyte apoptosis and improve cardiac function.

Turmeric (Curcuma longa). Curcumin, a natural polyphenol compound found in turmeric, has shown to exerts cardioprotective effects on patients with acute or chronic myocardial infarction. Turmeric offers antioxidant protection and is thought to have an inhibitory effect on NF-KappaB, an important mediator in inflammatory response.

Epigallocatechin-3-gallate (EGCG) is a derivative from green tea (Camellia sinensis) which has shown to offer many therapeutic effects on cardiovascular and metabolic diseases. 

What can aid recovery from pericarditisEGCG was found to exert profound anti-inflammatory, antioxidant, anti-infective, anticancer, antiangiogenetic, and chemo preventive effects. Including anti-cardiac hypertrophy – by inhibition of NF-KaffaB (inflammation), anti-myocardial infarction - by inhibition of MPO activity (implicated in coronary artery disease), anti-atherosclerosis - by inhibition of LDL cholesterol; antidiabetic by reducing plasma glucose and glycated haemoglobin levels; antioxidant protection – through inhibition of reactive oxygen species (ROS) generation.

Resveratrol belongs to the polyphenol group of compounds found in many plants, especially the skin and seeds of grapes. It is beneficial for its ability to inhibit bacteria and fungi; offers anti-tumor activity, antioxidant and anti-inflammatory activity; is a vasorelaxant and is cardio protective. In studies resveratrol showed beneficial effects in heart failure – by improving left ventricle function, decreasing hypertrophy, contractile dysfunction, remodelling and fibrosis. Over-all mproving cardiovascular function.

Immune system

Vitamin D, vitamin C, zinc and echinacea can help support the immune system to better fight infections.
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References

https://www.msdmanuals.com/professional/cardiovascular-disorders/myocarditis-and-pericarditis/pericarditis

https://www.msdmanuals.com/home/quick-facts-heart-and-blood-vessel-disorders/pericardial-disease/overview-of-pericardial-disease?query=pericardium

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pericarditis

Pericardial Friction Rub https://www.ncbi.nlm.nih.gov/books/NBK542284/

https://www.ecrjournal.com/journals/editions/ecr-volume-14-issue-2-summer-2019 https://www.ecrjournal.com/articles/anti-inflammatory-action-curcumin-use

Effects of curcumin on the apoptosis of cardiomyocytes and the expression of NF-κB, PPAR-γ and Bcl-2 in rats with myocardial infarction injury https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5228430/

Herbal Medicines for Inflammatory Diseases https://www.hindawi.com/journals/mi/2014/146832/

A mechanistic role for cardiac myocyte apoptosis in heart failure https://www.ncbi.nlm.nih.gov/pmc/articles/PMC155051/

Jing, Z. et al. Protective Effect of Quercetin on Posttraumatic Cardiac Injury. Sci. Rep. 6, 30812; doi: 10.1038/srep30812 (2016). https://www.nature.com/articles/srep30812

Epigallocatechin-3 gallate prevents pressure overload-induced heart failure by up-regulating SERCA2a via histone acetylation modification in mice https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6171916/

Molecular Understanding of Epigallocatechin Gallate (EGCG) in Cardiovascular and Metabolic Diseases https://pubmed.ncbi.nlm.nih.gov/28864169/

Resveratrol: A Double-Edged Sword in Health Benefits https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164842/

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