Heart, which is the chief organ that work to pump blood that carry oxygenated blood and deoxygenated blood to all parts of human organic structure. It is separated or septum into two parts which are right and left compartments. Both compartments consist of atrium and ventricle. This chief organ is located within the pectoral pit and enclosed by a fluid filled pouch named the pericardium. There are two events that happen when the bosom beats which are diastole stage and systole stage. These two type of events are called cardiac rhythm. Diastole stage is referred to the status when the bosom ventricles are relaxed and filled with blood. While systole stage is referred to the status when the bosom ventricles are contract and pumped out the blood to the arterias. ( hypertext transfer protocol: //biology.about.com/od/humananatomybiology/ss/heart_anatomy.htm ) In a normal bosom, there are three superimposed tissues which are endocardium, myocardium, and pericardium. The innermost bed that coated to the Black Marias Chamberss is called the endocardium. Myocardium or known as the bosom musculus is characterised by the midst middle bed of the bosom. The last bed of the bosom is known as pericardium. The pericardium is defined as a thin double-layered pouch that surrounds the bosom. It is working as protective bed that protect the bosom within the pectoral pit. The pericardium consists of two parts ; the first portion is the interior serous pericardium and the 2nd portion is the outer hempen pericardium. The serous pericardium consists of two beds which are the splanchnic and the parietal and between these two beds has a pericardiac pit. The splanchnic pericardium is known as the visceral pericardium which is the interior bed that contact with the myocardium of the bosom whereas the parietal pericardium is the outer that non contact to the myocardium itself. The map of hempen pericardium is to envelop the serous pericardium which is composed of dense conjunction tissues that connected to the stop and the base of the great vass.
Pericardial gush is one of the disease that is related to the thin double-layered construction or pericardium that mentioned before. This type of disease is defined as an inordinate aggregation of pericardiac fluid that exceeds the normal degree of the fluid volume. As the pericardiac pit is really limited infinite therefore the fluid within it can non transcend the normal degree volume. When those conditions occur, it may take the rise of intrapericardial force per unit area that will give negative feedback or complication to the bosom and upset the normal map of this chief organ. One of the common complications is cardiac temponade. In this status, bosom that has been compressed will avoid the blood from come ining the bosom. Therefore, when less volume of the blood come ining the bosom Chamberss, there is less end product volume of the blood pumped to whole parts of the organic structure. Heart failure or decease can happen when a individual suffered from pericardiac gush. ( http: //www.cardiachealth.org/your-pericardium # Top )
Description of the disease
Pericardial is the word mentioning to pericardium or related to the country around the bosom ( pericardiac pit ) while gush is defined as escaped of fluid into the organic structure pit. Pericardial gush is an unnatural aggregation of pericardiac fluid in the pericardiac pit. The normal sum of pericardiac fluid is approximately 15 to 50 milliliters. ( hypertext transfer protocol: //en.wikipedia.org/wiki/Pericardial_effusion ) Pericardial gush normally related to redness of pericardium pouch that consequence from disease or any hurt affecting additions in fluid whether blood accretion or any unstable come ining the pericardiac pit. It may besides happen after surgical process or hurt. The inordinate fluid or blood in the pericardiac pit can increase intrapericardial force per unit area therefore give inordinate force per unit area to the bosom. This will upset the physiology of the bosom and if it non treated it may take to human death. ( http: //www.mayoclinic.com/health/pericardial-effusion/DS01124 ) The volume of the fluid in the pericardiac pit may run from a few milliliters and rises to two milliliters. There is several types of gush and it may be a transudative, exudative, hemorrhagic and malignance. Transudative gush frequently related to myxedemas and nephritic syndrome. Exudative is normally related TB and empyema. Haemorrhagic gush is due to trauma, rupture of aneurisms and malignant gush. Malignant gush is due to aggregation of unstable consequence from the metastasis procedure. ( hypertext transfer protocol: //en.wikipedia.org/wiki/Pericardial_effusion )
Cause of the disease
Pericardial gush can be categorized as inflammatory upset. An redness of pericardium or besides known as pericarditis is one of the causes that lead to this disease.
Pericardial gush besides can be result from perturbation of the pericardiac fluid flow such as obstruction or aggregation of blood in the pericardiac pit. However, there is still uncomplete happening that shows some diseases can do to pericardiac gush and sometimes it is idiopathic. But there are some specific causes that result to this disease which may associate to ;
Infections from viral, bacterial, fungous or parasite
Inflammation of pericardium pouch that consequence from unknown cause
Inflammation of pericardium due to old bosom surgery
An immune system upsets that result in redness and tissue harm, such as arthritic arthritis or lupus ( several disease which causes lesions
Less thyroid endocrine been produce from thyroid secretory organ or known as hypothyroidism besides may take to pericardiac gush as it may construct up fluid around the bosom in extra volume.
Virus such as Human Immunodeficiency Virus ( HIV ) or Acquired Immunodeficiency Syndrome ( AIDS )
Metastasis procedure of cancerous cell which may located in the lungs, chest or any next construction to the bosom
Cancer of pericardium or bosom itself
Acute radiation dosage exposed to the bosom
Motor vehicle accident ( trauma that cause puncture and shed blooding into pericardiac pit
Drugs experience such as medicine for high blood pressure ( Apresoline ) and medicine for epilepsy ( diphenylhydantoin )
( hypertext transfer protocol: //www.mayoclinic.com/health/pericardial-effusion/DS01124 )
Anatomic portion involved
As stated before, pericardiac gush is a common pathology that is related to the bosom organ fundamentally and specifically related to the bed of the bosom called pericardium.
Pericardium define as a dual layered membrane which environing the bosom. Pericardium has little sum of fluid that called pericardiac fluid in the infinite between the two layered membrane and the infinite is called pericardiac pit. The fluid within the infinite fundamentally protects the bosom from any peripherals daze or dork. Pericardium bed are characterized by two beds which are the outermost hempen pericardium and the interior serous pericardium. The interior serous pericardium itself is consists of two other beds which are parietal pericardium and splanchnic pericardium. The parietal pericardium as attach together with the outermost hempen pericardium and while the splanchnic pericardium is the bed that attach to the outer musculus of the bosom and it is called visceral pericardium. Pericardial pit that mentioned before is really situated between the parietal and splanchnic pericardiac beds.
The physiology of the pericardium and pericardiac fluid is to do certain the bosom in its place and guarantee there is no motion beyond the bound. Layer of pericardium besides work as a barrier that protect the bosom from infected by other next organ. It besides avoid the bosom from overly distend if in instances of overladen volume. Pericardial fluid map as lubricating fluid in order to cut down the clash around the bosom.
( hypertext transfer protocol: //en.wikipedia.org/wiki/Pericardium )
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Signs and symptoms
There are a few of normal marks and symptoms that occur when a individual suffer from pericardiac gush which are chest hurting, shortness of breath and low blood force per unit area ( Wiki 2013 ) .
Symptom is more associated with the patient ‘s perceptual experience, and more on what patient ‘s feel related to the disease. In the instance of pericardiac gush harmonizing to Dr W. Halley, cited in Dr Colin Tidy ( 2012 ) , the symptoms present, is rely on the velocity of unnatural accretion of the fluid in the pericardiac pit and besides the size of the gush. Almost all of little to chair gush and take a longer period of clip to organize an gush will look symptomless or less symptoms will be exist. In the other instance, even a little unnatural aggregation of pericardiac fluid but quickly occur may do to tamponade and upset the normal circulation.
The most common symptoms consequences from pericardiac gush are chest hurting, edginess and feeling force per unit area in the chest country. This thorax hurting is placing with pericardiac hurting. Pain caused by pericardiac hurting can be eliminated or relieved by lying prone or posing and will farther reduced by lying in a supine place ( Dr W. Halley, cited in Dr Colin Tidy 2012 ) .
Besides chest hurting, patient will see light-headedness. This type of symptom is a common and frequently unpleasant esthesis of giddiness or feeling that he or she may approximately to conk. In some instances, the person may experience as though his or her caput is weightless. The individual may besides experience as the topographic point around him or her is “ whirling ” or traveling or known as dizziness ( Dr W. Halley, cited in Dr Colin Tidy 2012 ) .
The other symptom that may patient feel is palpitation. Palpitation is an abnormalcy of pulse that ranges from frequently unnoticed skipped beats or increased bosom rate to really noticeable alterations accompanied by giddiness or trouble in take a breathing. Cough, shortness of breath and gruffness are other common symptoms that occur when patient suffer from pericardiac gush. Hoarseness or raggedness is defined as upset of voice or other sound ( Dr W. Halley, cited in Dr Colin Tidy 2012 ) .
Patient may besides see anxiousness and confusion. These sorts experiencing sometimes accompanied with patient consciousness. Sometimes patient loss of ability to put him or herself right in the universe by clip, location and personal individuality ( Dr W. Halley, cited in Dr Colin Tidy 2012 ) .
Harmonizing to Dr W. Halley, cited in Dr Colin Tidy ( 2012 ) describe that hiccup is besides the symptom that will show due to pericardiac gush. A hiccup or hiccough is defined as nonvoluntary cramp of the stop and pharynx musculuss accompanied by an disconnected sound of “ hic ” .
The intervention for pericardiac gush is depending on the volume of unnatural aggregation of the fluid within the pericardiac pit, the causes of pericardiac gush and what sort of complication will happen if patient suffer from pericardiac gush ( Mayo Clinic staff 2010 ) .
Harmonizing to Wiki ( 2013 ) , the intervention used for pericardiac gush is based on the cause and the earnestness of the bosom defect. If the gush is due to the infection of virus, it frequently disappeared without any intervention within a hebdomad. There is a few of gushs have no patterned advance in it badness and they ne’er need any intervention at all.
There are many methods in handling gushs as harmonizing to Mayo Clinic staff ( 2010 ) such as utilizing anti inflammatory medicines and besides via invasive process. Harmonizing to Mayo Clinic staff ( 2010 ) describe that there is no pressing intervention if the person non holding any perturbation physiology of the bosom such as tamponage, and physician or experts will order for intervention for redness of pericardium that may ensue in pericardiac gush. The used of drug such as acetylsalicylic acid or known as acetylsalicylic asid can cut down the redness that can do pericardiac gush. Aspirin is besides the medicine used to alleviate hurting ( Mayo Clinic staff 2010 ) .
Nonsteroidal anti inflammatory drugs ( NSAIDs ) are drugs with analgetic and antipyretic that can give anti inflammatory consequence such as Indocin or isobutylphenyl propionic acid. Another anti inflammatory drugs used for handling pericardiac gush is colchicines ( colcrys ) , that is normally used to handle urarthritis, familial Mediterranean febrility, pericarditis and besides use as antineoplastic drug ( Mayo Clinic staff 2010 ) .
Beside the used of anti inflammatory drugs, harmonizing to Mayo Clinic staff ( 2010 ) an invasive process is use to pull out the gush and the last pick method usage if anti inflammatory drugs can non bring around the gush because it is excessively big or the gush still reiterating after it had been successfully cured.
Pericardiocentesis is one of the invasive processs used. Through this process, the experts will utilize a needle and catheter to pull out the gush from the pericardiac pit under fluoroscopic or echocardiography as the imagination modes and counsel to do the process possible ( Mayo Clinic staff 2010 ) . During this process is conducted, the patient ‘s bosom is observe with the ECG machine. In some instances, the catheter that had been inserted into the pericardiac pit is left indoors in order to run out the gush if there is reaccumulation occur ( Mayo Clinic staff 2010 ) .
Pericardial gush besides can be cure with open-heart surgery. Harmonizing to Mayo Clinic staff ( 2010 ) , unfastened bosom surgery normally done to the patients who suffer gush due to the accretion of blood which may be caused by old bosom surgery or other factor. This process surgery is used to run out out the blood accretion and mend the harm to the pericardium such as rupture of pericardium.
Imaging modes used
Harmonizing to Vibhuti N Singh ( 2011 ) describe that, in imagination of pericardiac gush, there are many types of method approached in order to bring forth the most accurate and most sensitive result about this disease. In order to accomplish that peculiar ground echocardiography, computed imaging ( CT scan ) , and besides magnetic resonance imagination ( MRI ) had been used to measure pericardiac gush. Those of imaging modes are really sensitive to acknowledge the visual aspect of gush even the gush is at the normal degree of volume.
The normal pericardiac fluid is been considered when there is non presence of any pericardiac disease. In echocardiography, normal volume of pericardiac fluid will look as free infinite between splanchnic bed and parietal bed during the bosom ventricles contract and pump blood to the arterias ( systole stage ) and during the bosom ventricles are relaxed and the bosom fills with blood ( diastole stage ) less than 1 millimetre division will be visualise between those pericardiac bed. However echocardiography will hold a positive gush as the consequence when there is fat between the pericardiac beds but there is otherwise for MRI and CT scan ( Vibhuti N singh 2011 ) .
Harmonizing to Vibhuti N Singh ( 2011 ) describe that, with the used of apparent x-ray nor fluoroscopy, they have non truly play an of import function in order to name pericardiac gush disease. These sorts of modes are merely recommended when there is patient enduring with big gush ( Vibhuti N Singh 2011 ) . They normally produce a questionable result as they produce a low grade of diagnostic information. There may bring forth false positive information and sometimes false negative information. The images produce by fluoroscopy or kick x-ray may hold the possibility to be misdiagnose by radiotherapist whether it is pericardiac gush or megalocardia due to the trouble to separate between two of them ( Vibhuti N Singh 2011 ) .
Changes required and imaging considerations