Versamento pericardico, cause sintomi cura

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Il cuore è circondato da una struttura protettiva, il pericardio, a doppio strato, tra i quali è normalmente contenuta una minima quantità di liquido. In presenza di una malattia la quantità di liquido può aumentare eccessivamente ed in questi casi si parla di versamento pericardico che può portare insufficienza cardiaca pericolosa.

 

versamento pericardico cause sintomi cure

 


Versamento pericardico, i sintomi

Non sempre sono evidenti sintomi di questa condizione, specie se l’accumulo di liquido avviene lentamente. Se invece è rapido si possono avere dei disturbi. In generale i sintomi di un versamento pericardico possono essere:

  • Dispnea (respiro corto o comunque difficoltà di respirazione)
  • Ortopnea (difficoltà nella respirazione da sdraiati)
  • Dolore al torace
  • Tosse
  • Febbricola
  • Frequenza cardiaca accelerata

 

 

Versamento del pericardio, quali cause?

L’infiammazione del pericardio (pericardite) è la risposta ad una malattia, infortunio o infiammazione che colpisce il pericardio. Il versamento (o effusione) è spesso un segno di questa risposta infiammatoria.
Il versamento pericardico può verificarsi anche quando il flusso dei fluidi nel pericardio è bloccato o quando il sangue si accumula all’interno dello stesso. Non è chiaro come alcune malattie contribuiscano a tale situazione e, talvolta, la causa non può essere determinata. Per entrare più nel dettaglio, tra le cause più comuni troviamo:

  • Infezioni virali, batteriche, fungine o parassitarie
  • Infiammazione del pericardio conseguente ad intervento chirurgico al cuore o ad un attacco di cuore (sindrome di Dressler)
  • Malattie autoimmuni, come l’artrite reumatoide o il lupus
  • Insufficienza renale (uremia)
  • Ipotiroidismo
  • Metastasi
  • Tumore del pericardio
  • Radioterapia (se il cuore è nel campo di irradiazione)
  • Alcuni trattamenti chemioterapici
  • Trauma vicino al cuore
  • Alcuni farmaci da prescrizione come l’ idralazina per la pressione alta, l’isoniazide per la tubercolosi o la fenitoina per le crisi epilettiche
  • Versamento pericardico idiopatico (non se ne conosce la causa)

 

 

 

Complicanze

Il pericardio può contenere solo una quantità limitata di liquidi in eccesso senza causare problemi. Lo strato interno del pericardio è costituito da un singolo strato di cellule che si attacca al cuore. Lo strato esterno è più spesso e solo leggermente elastico: quando si raccoglie troppo liquido il pericardio si espande verso l’interno, verso il cuore, provocando pressione e dunque alterandone il corretto funzionamento, fino al rischio per la vita se non trattato.

 

 

Test e diagnosi

Un versamento del pericardio si può diagnosticare grazie ai seguenti test ed esami:

  • Auscultazione con stetoscopio (in caso di versamento il battito cardiaco risulta attutito)
  • Ecocardiogramma (normale, transtoracico o transesofageo a seconda dei casi)
  • Elettrocardiogramma
  • Radiografia del torace
  • Altre tecnologie di imaging (come la TAC o la Risonanza Magnetica)

 

 

 

Terapia

La terapia per un versamento pericardico dipende dalla quantità di liquido accumulato, dalla causa e del rischio di insufficienza cardiaca più o meno immediato. Possono dunque essere usati farmaci antinfiammatori (come l’aspirina o l’ibuprofene) o corticosteroidi, ma in caso di rischio maggiore il cardiologo può raccomandare delle tecniche atte a drenare il liquido in eccesso che vanno dalla semplice aspirazione con drenaggio all’intervento chirurgico.

 

 

Leggi anche:

Esami del sangue per le malattie cardiache

Elettrocardiogramma, come si fa e a cosa serve

Stenosi carotide, tutte le cure

Stenosi carotide, complicanze da evitare e diagnosi

 

 

Foto: Thinkstock

Fonte: Mayo Clinic

 

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