Causes, Symptoms, Treatment & Complications of Fibrinous Pericarditis

Submitted by Nic on February 28, 2013

Fibrin can be described as the prime factor of a person's coagulation system. This substance is located in the plasma in its inactive precursor-fibrinogen form. In case you suffer from a case of severe acute inflammation, the fibrinogen in the tissue turns into fibrin and covers the upper surface of the affected organ with a whitish coating. When this kind of inflammation occurs in the pericardium or the outer surface of your heart, it is referred to as fibrinous pericarditis. Because of its appearance, this condition is also often known as "bread and butter pericarditis" or a "hairy heart".

Fibrin is a sticky substance that covers the pericardium like a thin layer of batter, as if large amounts are poured on the surface of the heart. As your heart contracts and relaxes rhythmically, the fibrin sticks to the inner part of the heart sac and the outer part of the heart. The meeting and separating of the two surfaces drain the fibrin, giving it a hairy, threadlike appearance, which covers the pericardium.

Causes

Fibrinous pericarditis occurs when there is an inflammation, accompanied by fine granular roughening in the pericardium. Given below are some of the possible causes of this condition -

  • Undergoing radiation therapy
  • Chronic renal failure (uremia)
  • Acute rheumatic failure
  • Tuberculosis
  • Cancer
  • Viral and bacterial infections
  • Heart surgery or cardiac trauma
  • Connective tissue disease
  • Dressler syndrome or myocardial infarction
  • Use of certain medication (rare)

Most of the causes of fibrinous pericarditis are quite serious and require immediate medical intervention. Therefore, it is important that you get in touch with a doctor without any delay, in case you notice any of the signs and symptoms of this condition.

Symptoms

The symptoms of pericarditis may vary, depending upon the type and severity of the condition. One of the first warning signs that you may experience is a sharp, stabbing pain in the left side of your chest, or just behind your breastbone. In some instances, the discomfort may be more like a dull or a pressurizing chest ache. The pain could soon spread to your neck and left shoulder. Some of the factors that could worsen the discomfort to a great extent are coughing, inhaling deeply, swallowing, bending, leaning forward or lying down. In some instances the pain is so severe that people mistake it for a heart attack. In addition to the pain, you may also experience other signs and symptoms, such as -

  • Fever
  • Shortness of breath
  • Weakness and fatigue  
  • General feeling of illness
  • Dry cough
  • Swelling in the leg or abdomen

The symptoms of pericarditis are quite similar to those associated with other heart and lung conditions. Since early treatment increases the chances of recovery, it is important to consult a doctor as soon as you notice any of the symptoms mentioned above. Your doctor may ask you to undergo a blood test, along with a few screening tests like chest x-rays, ECG, CT scan or MRI for an accurate diagnosis.

Treatment

Many cases of pericarditis get resolved within 2 to 3 weeks. However, a conservative path may be followed in the treatment of acute fibrinous pericarditis. Given below are some of the treatment options that may be considered -

  • Dialysis, for patients with effusion
  • NSAID, especially if the patient is suffering from fever
  • Morphine for alleviating chest pain
  • Antibiotics, in case of a bacterial infection
  • Surgical procedures like pericardiocentesis and pericardiectomy

Left unchecked, patients suffering from this condition can develop long-term complications such as cardiac tamponade or permanent thickening and scarring of the pericardium. Therefore, it is absolutely essential to ensure that fibrinous pericarditis is closely monitored by a doctor and timely treatment is followed.

References

  • Lawrence M. Boxt et.al, From the RSNA Refresher Courses Cardiac MR Imaging: A Guide for the Beginner, July 1999 RadioGraphics, 19, 1009-1025
  • U Sechtem et.al, MRI of the abnormal pericardium : American Journal of Roentgenology, Vol 147, Issue 2, 245-252
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