Definition and causes
Armored Heart is the name for a heart that can not be adequately filled with blood because of a thickened and stiff pericardial sac around it. This reduces pumping ability.
The heart surrounded by a double layer pericardial sac (called perikardiet). The innermost layer has grown along with the extreme of the heart, and the outer layer of the heart bag stuck to the agencies around the heart (including lungs and diaphragm). In between the two leaves, there is a thin liquid film that makes the heart can beat almost smooth.
An inflammation may be present in the heart sac, and then called it perikarditis. Konstriktiv perikarditis (armored heart) occurs after an acute perikarditis that goes into a chronic phase, which formed arvæv in the heart sac, and when this eroding. The two sheets of heart sac forkalke and can be hard, hence the name armored heart.
Earlier this condition most often seen by tuberculosis, but tuberculosis is now extremely rare in Denmark. Other bacterial infections may also trigger heart armor. The development is also seen after radiotherapy.
Symptoms of armor heart
The rigid pericardial sac makes the heart can not be filled with blood in a sufficient way. As compensation increased pressure in the veins (the veins that lead blood back to the heart), and symptoms of so-called right sided heart failure:
- There is shortness of breath and fatigue.
- There can be seen venestase (blood accumulation) of the veins in the neck.
- The increased pressure in the veins burden the body's smallest blood vessels and fluid squeezed out of the body's tissues. There appears swelling, called edema. Most clearly seen in the legs as swollen ankles and feet, and in severe cases, swelling of the purse. In bedridden seen edema on the lower-lying parts of the body (shoulder lot korsben and heels).
- Venestase in the legs can give fragile skin on their feet, and there can be formed eczema (staseeksem). There may be problems with ulceration (venous leg ulcer) and poor healing.
- In severe cases, the liver swell (leverstase) and give pain from the upper right part of the stomach. This can at worst lead to cirrhosis (cirrhosis).
- There may be leakage of free fluid in the abdominal cavity (ascites), so stomach volume grows.
- There is often forkammerflimmer
The doctor may use a variety of studies to make the diagnosis. There will always be an electrocardiogram (ECG) of the heart.
An X-ray of the breast can sometimes show calcification of the heart sac.
An echocardiography is an ultrasound of the heart, and it may show whether the heart is filled and the pumps properly.
Not infrequently, it is necessary to introduce a catheter (a small tube) in the heart, to measure the pressure inside the heart. It may also be necessary to take a tissue (a biopsy).
Treatment of armor heartWe will seek treatment with Diuretics (diuretics), to lower blood pressure in the veins and not to unnecessarily burden the heart.
Blood pressure, however, often continue to grow, and the diastolic blood pressure (the low value) at a critical time high, there is a need for surgery. This is a relatively large operation where you enter through the sternum and remove the fortykkede pericardial sac.
Select and complications
Untreated disease leads to death because the heart pump function can not be maintained.
About 50% of operating are completely symptom-free, and 9 out of 10 feel better after surgery. However, there is a mortality rate of approximately. 10% associated with the operation.
Five years after surgery, 80% still alive.