Surgery in acute and chronic pericarditis. Pathophysiology and management

Area of Science:

• Cardiology
• Thoracic Surgery
• Pathophysiology

Background:

• Pericarditis management has evolved, with tuberculosis decreasing and uraemic pericarditis increasing.
• Modern treatments like dialysis and transplantation necessitate vigorous management of uraemic pericarditis.
• The pathophysiology involves capillary permeability and mesothelial cell integrity, influencing disease progression.

Purpose of the Study:

• To review the surgical management of 42 pericarditis cases.
• To discuss the pathophysiology across acute, recurrent, and chronic pericarditis stages.
• To advocate for early surgical intervention in specific pericarditis cases.

Main Methods:

• Retrospective case review of 42 surgically treated pericarditis patients.
• Analysis of etiological factors and disease progression.
• Microscopical and laboratory investigations into pericardial effusion development.

Main Results:

• Tuberculosis is now rare, while uraemic pericarditis is increasingly seen.
• Surgical cure is effective for uraemic pericarditis, even with advanced renal disease.
• Early surgery provides lasting relief with minimal risk for most patients.

Conclusions:

• Vigorous treatment, including surgery, is crucial for uraemic pericarditis.
• Rapid surgical intervention is advised for impending tamponade and unresponsive acute cases.
• Surgery is preferred over long-term medical treatment for recurrent and chronic pericarditis to prevent myocardial and liver damage.