Calcified Pericardium: Causes, Symptoms, and Treatment

Introduction

Calcified pericardium refers to the thickening and hardening of the pericardium, the sac surrounding the heart, due to the deposition of calcium. This condition is often associated with constrictive pericarditis, which restricts the heart's movement and affects its ability to pump blood efficiently.

Causes

The main causes of pericardial calcification include: - Chronic pericarditis (long-term inflammation of the pericardium) - Tuberculosis (a historical but still possible cause in some regions) - Uremia (often due to chronic kidney disease) - Previous heart surgery or radiation therapy - Recurrent viral or bacterial infections - Idiopathic causes (unknown reasons)

Symptoms

Symptoms of a calcified pericardium can range from mild discomfort to severe heart failure symptoms: - Shortness of breath (especially during exertion) - Fatigue and weakness - Swelling in the legs and abdomen (due to fluid buildup) - Chest pain or discomfort - Jugular venous distension (a visible swelling of the neck veins due to increased pressure)

Diagnosis

To diagnose a calcified pericardium, doctors use a combination of methods: - Chest X-ray (can show calcium deposits in the pericardium) - Echocardiography (to assess heart function and movement restrictions) - CT Scan or MRI (provides detailed imaging of the pericardium and the extent of calcification) - Cardiac catheterization (to analyze heart pressures and confirm constriction)

Treatment

Treatment depends on the severity of the symptoms and the impact on heart function: - Medications: Diuretics can help reduce fluid buildup and ease symptoms. - Pericardiectomy: This is the surgical removal of the calcified pericardium, which is the definitive treatment for severe cases. - Management of underlying conditions: If infections or kidney disease are responsible, addressing the root cause is essential.

Prognosis

Without treatment, severe calcified pericardium can lead to heart failure. Surgical removal of the calcified pericardium can significantly improve symptoms and quality of life for many patients.

Conclusion

A calcified pericardium is a serious but treatable condition that requires careful diagnosis and intervention. If you experience symptoms suggestive of this condition, consult a cardiologist for a thorough evaluation.

Source recommendations

1. American Heart Association Guidelines for Management of Pericardial Diseases

1. https://www.ahajournals.org/doi/10.1161/circulationaha.105.561514
2. https://www.jacc.org/doi/10.1016/j.jacc.2019.11.021
3. https://www.sciencedirect.com/science/article/abs/pii/S1936878X24001608
4. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2020/01/07/10/59/Management-of-Acute-and-Recurrent-Pericarditis
5. https://www.heart.org/en/health-topics/pericarditis/what-is-pericarditis

2. European Society of Cardiology Guidelines on Pericardial Diseases

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Pericardial-Diseases-Guidelines-on-the-Diagnosis-and-Management-of
2. https://academic.oup.com/eurheartj/article/36/42/2921/2293375
3. https://pubmed.ncbi.nlm.nih.gov/26320112/
4. https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2015/10/30/12/01/2015-esc-guidelines-for-the-diagnosis-and-management-of-pericardial-diseases
5. https://pubmed.ncbi.nlm.nih.gov/15120056/