Lena Torres
Pericarditis is the inflammation of the pericardium, a sac-like organ with two thin layers of tissue that surround the heart. The pericardium holds the heart in place, protects it from infection, and keeps it from filling with too much blood. It also cushions the heart from outside pressure. In some cases of pericarditis, the tissues become swollen and irritated, leading to chest pain and possible fluid buildup around the heart. This fluid buildup can cause a pericardial knock, a high-pitched sound made by the heart when a ventricle does not fully fill with blood between heartbeats. This sound is an indicator of constrictive pericarditis, a severe form of pericarditis where the pericardium becomes hard and/or thick, impacting the heart's normal function.
| Characteristics | Values |
|---|---|
| Sound | A pericardial knock is a high-pitched sound made by the heart due to early diastole, as a ventricle does not fully fill with blood between heartbeats. |
| Cause | The sound is generally indicative of diastolic dysfunction, in which the heart stiffens, has difficulty relaxing between beats, and cannot completely fill with blood. |
| Diagnosis | A clinician will often first assess the individual's vital signs, symptoms, and medical history. A healthcare provider will listen to the heart for a pericardial rub or creaking sound using a stethoscope. |
| Tests | Blood test, EKG (electrocardiogram), Chest X-ray, Echocardiogram, Cardiac CT, Cardiac MRI, Cardiac catheterization |
| Complications | Cardiac tamponade, Chronic constrictive pericarditis, Pericardial effusion, Constrictive pericarditis, Pericardial thickening |
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What You'll Learn
- A pericardial rub is a creaking sound heard when the pericardium's inflamed lining rubs together
- Pericardial effusion is often painless but can cause pain when occurring with acute pericarditis
- Pericarditis can be caused by injury to the chest, such as a car accident
- Constrictive pericarditis is a severe form of pericarditis where the pericardium becomes hard and/or thick
- A pericardial knock is a high-pitched sound caused by a ventricle not fully filling with blood
A pericardial rub is a creaking sound heard when the pericardium's inflamed lining rubs together
Pericarditis is an inflammation of the pericardium, a thin, two-layered, fluid-filled sac that surrounds the heart. The pericardium holds the heart in place, lubricates it, shields it from infection and malignancy, and prevents it from over-expanding when blood volume increases.
When the pericardium is inflamed, the inner and outer layers no longer interact smoothly, and friction is created. This results in an audible pericardial friction rub, which is a hallmark of pericarditis. The sound is described as a harsh, "scratchy", grating, squeaky, or rasping noise, similar to sandpaper being rubbed on wood. It can vary in intensity and is usually best heard at the apex of the heart or the lower left sternal border.
The pericardial rub can be heard during auscultation, which is the act of listening to the sounds made by the body using a stethoscope. It is an extra heart sound with two systolic and one diastolic component, occurring in synchrony with the heartbeat and during both phases of respiration. The sound is often intermittent and may be louder than or may even mask the other heart sounds.
In addition to the pericardial rub, healthcare providers use a variety of methods to check for pericarditis and its complications, such as pericardial effusion or constrictive pericarditis. These methods include blood tests, chest x-rays, electrocardiograms (ECG or EKG), echocardiograms, cardiac CT scans, and cardiac MRIs.
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Pericardial effusion is often painless but can cause pain when occurring with acute pericarditis
Pericarditis is the inflammation of the pericardium, a sac-like organ with two thin layers of tissue that surround the heart. The pericardium holds the heart in place, protects it from infection, and keeps it from filling with too much blood. It also cushions the heart from outside pressure. Pericardial effusion is the presence of extra fluid in the space between the pericardial layers. This fluid buildup can compress the heart and cause severe chest pain.
Acute pericarditis is a condition that develops suddenly and is characterised by inflammation of the pericardium and the sudden onset of symptoms. It typically lasts less than four to six weeks. In some cases, acute pericarditis can lead to pericardial effusion, where there is a buildup of fluid in the pericardial cavity. This fluid can cause friction between the visceral and parietal layers of the pericardium, resulting in a characteristic "pericardial rub" sound that can be heard during auscultation.
Pericardial effusion is often painless, especially in mild cases. However, when it occurs with acute pericarditis, it can cause sharp chest pain that may radiate to the back, neck, or left shoulder. The pain may worsen with coughing, swallowing, deep breathing, or lying flat and improve when sitting up and leaning forward. In addition to chest pain, acute pericarditis with pericardial effusion can also cause other symptoms, including shortness of breath, anxiety, fatigue, and palpitations (irregular heartbeat).
If pericardial effusion is left untreated, it can lead to life-threatening complications such as cardiac tamponade. Cardiac tamponade occurs when there is a rapid accumulation of fluid in the pericardial cavity, causing increased pressure on the heart and impairing its ability to pump blood effectively. Symptoms of cardiac tamponade include chest pain, trouble breathing, lightheadedness, fainting, and a rapid heartbeat. In such cases, immediate medical attention is required.
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Pericarditis can be caused by injury to the chest, such as a car accident
Pericarditis is the inflammation of the pericardium, a sac-like organ with two thin layers of tissue that surround the heart. It holds the heart in place, protects it from infection, and keeps it from filling with too much blood. The pericardium also cushions the heart from outside pressure. A small amount of fluid keeps the layers separate and decreases the friction between them as the heart beats. However, in some cases of pericarditis, these tissues become swollen and irritated, leading to chest pain and possible fluid buildup around the heart.
Traumatic pericarditis is a type of pericarditis that develops as a result of an injury to the chest, such as a car accident. This injury causes inflammation in the heart, specifically in the pericardium (the lining around the heart). During diagnosis, a doctor will listen to the heart for a "pericardial rub," a rubbing or creaking sound caused by the inflamed lining of the pericardium. This sound is best heard when the patient leans forward, holds their breath, and breathes out. An electrocardiogram (ECG or EKG) may also be used to look for changes in heart rhythm, which are present in about half of all people with pericarditis. Other diagnostic tests include a chest X-ray, echocardiogram, cardiac MRI, and CT scan.
In most cases of pericarditis, patients make a full recovery with quick treatment. However, recurrent pericarditis can occur if not properly treated with medication. Additionally, severe cases of pericarditis, known as constrictive pericarditis, can lead to life-threatening complications. This occurs when the inflamed layers of the pericardium stiffen, develop scar tissue, thicken, and stick together, interfering with the heart's normal function. Symptoms of constrictive pericarditis include swelling in the legs, feet, and ankles, as well as shortness of breath with exertion.
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Constrictive pericarditis is a severe form of pericarditis where the pericardium becomes hard and/or thick
Pericarditis is inflammation of the pericardium, a sac-like organ with two thin layers of tissue that surround the heart. The pericardium holds the heart in place, protecting it from infection and ensuring it doesn't fill with too much blood. It also cushions the heart from outside pressure. In constrictive pericarditis, the pericardium becomes hardened and/or thickened, interfering with the heart's normal function. This severe form of pericarditis can cause the heart muscle to be compressed, leading to congestive heart failure.
Constrictive pericarditis is a condition where the walls of the fluid-filled pouch around the heart, the pericardium, become too stiff or thick. This restricts the heart's ability to expand and fill with blood between heartbeats. The pericardium is normally flexible and stretchy, but when it becomes stiffer and thicker than normal, it can cause severe complications. This condition often occurs after multiple episodes of acute pericarditis, and it can be challenging to diagnose due to its non-specific symptoms.
The pericardium's inflamed layers can develop scar tissue, thicken, and stick together, leading to ventricular filling restriction. This happens when the granulation tissue gradually contracts and encases the heart, sometimes becoming calcified. The thickened and scarred pericardium prevents normal respiratory pressure changes from being transmitted to the heart chambers. This results in decreased end-diastolic volume, stroke volume, and cardiac output.
Healthcare providers use various tests to diagnose constrictive pericarditis, including chest X-rays, electrocardiograms (ECG or EKG), echocardiograms, cardiac MRI, CT scans, and cardiac catheterization. These tests help assess the heart's function, identify any fluid buildup or inflammation, and determine the filling pressures in the heart. While constrictive pericarditis is a severe condition, it is often treatable, especially with early diagnosis. Treatment options may include surgery, medication, or other interventions to restore the pericardium's flexibility and ensure proper heart function.
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A pericardial knock is a high-pitched sound caused by a ventricle not fully filling with blood
Pericarditis is the inflammation of the pericardium, a sac-like organ with two thin layers of tissue that surround the heart. The pericardium holds the heart in place, protects it from infection, and keeps it from filling with too much blood. It also cushions the heart from outside pressure. In pericarditis, the tissues become swollen and irritated, causing sharp chest pain and potentially leading to fluid buildup around the heart.
In some cases, pericarditis can lead to a more severe form of the condition called constrictive pericarditis. This occurs when the inflamed layers of the pericardium stiffen, develop scar tissue, thicken, and stick together. Constrictive pericarditis can interfere with the heart's normal function, preventing it from fully filling with blood during beats. This condition can be caused by various factors, including bacterial, viral, fungal, or parasitic infections, as well as cancer, surgery, or kidney failure.
A pericardial knock is a high-pitched sound that occurs in early diastole when the ventricles do not completely fill with blood between heartbeats. This sound is often a sign of constrictive pericarditis, indicating that the heart is stiffened and having difficulty relaxing between beats. The pericardial knock is one of the cardiac sounds used by physicians during the diagnosis of constrictive pericarditis, along with the pericardial rub, which is the sound of the pericardium rubbing against the heart due to constriction.
To diagnose constrictive pericarditis, clinicians will assess vital signs, symptoms, and medical history. Imaging tests such as electrocardiograms, echocardiograms, chest X-rays, and cardiac MRIs may also be used. Treatment for constrictive pericarditis focuses on addressing the underlying cause, and may include anti-inflammatory medications, diuretics, and lifestyle changes such as reducing salt intake. In severe cases, a pericardiectomy may be required.
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Frequently asked questions
Pericarditis is inflammation of the pericardium, a sac-like organ with two thin layers of tissue that surround the heart.
Pericarditis can cause a "pericardial rub", a rubbing or creaking sound. It can also result in a "pericardial knock", a high-pitched sound caused by a ventricle not fully filling with blood between heartbeats.
A healthy heartbeat makes a "lub-dub" sound. The first "lub" sound is from the closing of the atrioventricular valves, and the second "dub" sound is from the closing of the semilunar valves.
