Another name for the pericardium is the pericardial sac. The heart contracts inside this bag. If the amount of fluid between the sheets of the pericardium exceeds 200 ml, then the work of the organ becomes difficult, and with a large amount of transudate in the pericardium, clinical symptoms occur that worsen the patient's well-being and aggravate heart failure. A slight accumulation of transudate in itself does not cause the appearance of clinical symptoms and complaints of the patient about feeling unwell. Often, the hydropericardium is not detected during life, but is detected only after death.
The pericardium is a connective tissue membrane of the heart (bag, shirt), consisting of two sheets (layers), between which a small amount of transudate is distributed. The volume of this liquid should not exceed the norm of 15-50 ml.
Most often, the hydropericardium is one of the symptoms of dropsy, occurs with congestive heart events caused by circulatory disorders. Other causes of hydropericardium include:
Less commonly, the causes of hydropericardium are the use of anti-inflammatory nonsteroidal drugs, vasodilators.
Hydropericardium is noted with myxedematous heart, hemorrhagic symptom, with the growth of malignant tumors. The cause of the accumulation of transudate in the pericardial sac may be a mechanical obstruction that interferes with the outflow of blood from the pericardium. Such obstacles include growing tumors of the mediastinum, lungs.
Hydropericardium as one of the symptoms accompanies heart disease. Non-inflammatory fluid accumulates in the pericardial sac with cardiomyopathy, myocarditis, and acute heart failure. The accumulation of fluid in the pericardial sac is caused by a violation of protein synthesis caused by a deficiency of thyroid hormones in thyroid disease. The tissues accumulate hyaluronic, chondroitinsulfuric acid, mucin, capable of retaining water in the body.
Water retention is observed throughout the body, including in the pericardial connective tissues. The release of this serous fluid into the pericardium causes the development of the hydropericardium. In hypothyroidism, echocardiography reveals accumulation of water of 15-100 ml, accumulation of transudate in large volumes is less common.
The stages of hydropericardium differ depending on the amount of accumulated transudate in the pericardial sac.
Depending on the characteristics of the composition of the transudate, the following forms are distinguished: Depending on the cause that caused the accumulation of transudate in the pericardial sac, the signs of this phenomenon will vary, but all forms of the disease are characterized by an increase in symptoms depending on the stage of the disease.
At the third stage in the pericardial saccan accumulate up to 1 liter of transudate. At the stage of small hydropericardium, the fluid accumulating in the pericardial sac does not show any symptoms. Unpleasant sensations in the chest area appear at the stage of moderate hydropericardium. At the stage of large hydropericardium, the heart is compressed so that its ability to relax is impaired.
The accumulation of fluid in the pericardium does not always aggravate the course of heart disease. In some conditions, a small amount of transudate in the pericardial sac has a stabilizing effect on the myocardium, and exhibits supporting properties in severe heart failure.