The heart is one of the most important organs in our body. It's like the engine of a car, right? But did you know that this heart is not alone, it also has a special protective covering, or rather, a sac, around it? Today we are talking about this protector of our heart, or what is medically known as the pericardium.
Simply put, what is the pericardium?
The pericardium is a protective, fluid-filled sac that surrounds your heart. It helps the heart work properly. This sac covers not only the heart, but also the beginnings of the major blood vessels (also called "great vessels") that lead from the heart.
That means main veins like this:
- Aorta
- Main pulmonary artery
- Pulmonary veins
- Superior and inferior vena cava
What are the main functions of the heart?
Just imagine how much work this little bag can do. Here are some of its main functions:
- Protecting the heart: This acts like a cushion that protects the heart from external shocks and impacts, even if we fall or hit our chest somewhere.
- Keeping the heart in one place: This helps keep the heart in its proper place inside the chest, without it moving around.
- Stopping the heart from getting too big: When the heart fills with blood, this covering controls the heart from swelling too much and filling it with too much blood.
- Protecting against infections: This helps prevent infections from spreading to the heart from surrounding tissues, for example, the lungs.
- Reducing friction: Provides lubrication to reduce the friction that occurs when the heart beats against surrounding tissue.
Where is this heart located?
The pericardium is located in our chest, surrounding the heart. You know, the heart is located in the front of the chest, a little to the left of the middle bone (sternum). But very rarely, some people's hearts are located on the right side, which we call ``dextrocardia''. In such a person, the pericardium is also located on the right side.
Let's learn about the layers of the pericardium.
This sac called the pericardium is made up of two main layers. This is a bit complicated, but let's understand it simply.
| Layer | Description |
|---|---|
| Fibrous pericardium | This is the strongest, outermost layer of the pericardium. It is made up of connective tissue. This layer prevents the heart from getting too big. It is attached to the major blood vessels above the heart and to the diaphragm below. |
| Serous pericardium | This is the innermost layer. But it's actually made up of two other layers . This layer produces the fluid that lubricates the heart when it beats, called pericardial fluid. |
| The two layers of the serous pericardium | |
| Parietal layer | This is the outermost layer of the pericardium. It is firmly attached to the fibrous pericardium above it. |
| Visceral layer | This is the innermost layer of the pericardium. It is tightly attached to the heart and the roots of the major blood vessels. We also call this the epicardium . |
The small empty space between the two layers of the pericardium (lateral and intercostal) is what we call the pericardial cavity . The previously mentioned lubricating substance, that is, the pericardial fluid, is inside this cavity.
What are the diseases that affect the heart?
Like the heart, this heart valve can be affected by various medical conditions. Here are some of them:
| Medical condition | Simply put... |
|---|---|
| Pericarditis | Inflammation or infection of the pericardium. This can occur suddenly (acute) or over a long period of time (chronic). |
| Constrictive pericarditis | A condition in which the pericardium becomes thickened and stiff, preventing the heart from pumping properly. |
| Pericardial effusion | The amount of fluid inside the pericardial sac is much higher than normal. |
| Cardiac tamponade | This is a very dangerous condition . The pericardial sac becomes overfilled with fluid, which puts pressure on the heart from the outside. This prevents the heart from filling with blood properly. |
| Pericardial cysts | Things like tumors that form on the pericardium. These may sometimes cause no problems, but sometimes they can grow and put pressure on the heart or lungs. |
What happens if the pericardium is damaged?
Normally, the pericardium is flexible and stretchy, so it can expand as the heart fills with blood and contract as it pumps blood.
But when a disease affects the heart, it loses this flexibility. Then the heart cannot pump as well as it should. As a result, the heart cannot pump the amount of blood the body needs. This can lead to dangerous complications like heart failure and cardiogenic shock .
What are the symptoms of a heart valve problem?
Although symptoms vary depending on the underlying condition, here are some common symptoms:
- Chest pain: This can be a sharp, stabbing pain. It may also radiate to the arm, back, or neck. It may be worse when coughing, swallowing, taking a deep breath, or bending over.
- Dizziness or lightheadedness.
- Dry cough.
- Rapid heartbeat (tachycardia) or an abnormal feeling of the heart beating.
- Feeling very tired (Fatigue).
- Fever.
- Back, neck, or shoulder pain.
- Difficulty breathing (dyspnea).
- Swelling in the abdomen or legs (edema).
- Difficulty swallowing (dysphagia).
What tests are done to identify such problems?
When you visit your doctor with symptoms like these, they may perform one or more of these tests to accurately diagnose the condition:
- Blood tests: Check for infections, immune system diseases, and inflammation.
- Chest X-Ray
- Cardiac computed tomography (CT scan)
- Echocardiogram (Echocardiogram - echo): An ultrasound scan of the heart.
- Electrocardiogram (ECG/EKG)
- Left and right heart catheterization
What are the treatments for coronary artery disease?
Treatment depends on your condition and its severity. Your doctor will discuss the best treatment option for you. Some of the most common treatments include:
- Antibiotics or antifungal medications: If the cause of the heartworm disease is a bacterial or fungal infection.
- Rheumatologic drugs: If the cause of the disease is a medical condition such as lupus or rheumatoid arthritis.
- Anti-inflammatory medications: Reduce swelling and pain.
- Diuretics: Medicines given to remove excess fluid from the body.
- Pericardiocentesis: Removal of excess fluid that has accumulated in the pericardial sac using a needle.
- Pericardiectomy: Surgical removal of part or all of the pericardium.
- Video-assisted thoracic surgery (VATS): A surgery performed through a small incision to remove excess fluid.
How can I keep my heart healthy?
The best thing you can do is to adopt a heart-healthy lifestyle. Conditions like heart disease can also cause heart valve problems. So, reducing that risk can help keep your heart valve healthy.
These things are important for a heart-healthy lifestyle:
- Eat a heart-healthy diet.
- Exercise regularly as directed by your doctor.
- Manage medical conditions like high blood pressure, high cholesterol, and diabetes.
- Use the medications prescribed for you exactly as prescribed.
- Have annual medical checkups.
Also, if you have other medical conditions, such as cancer, lupus, or HIV, talk to your doctor about how they might affect your heart. Some heart surgery or radiation therapy can also cause heart problems, so it's important to ask your doctor about that as well.
Take-Home Message
- The pericardium is an important sac that surrounds your heart, protecting it and helping it function properly.
- A sharp chest pain that worsens when bending over, breathing, or coughing can be a key symptom of a related condition.
- Some conditions that affect the heart, such as cardiac tamponade, can be very dangerous. So don't ignore the symptoms.
- Maintaining your overall heart health is the best way to keep your heart healthy.
- If you have these symptoms, definitely see a doctor immediately and seek advice.
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