Pericarditis risks
Pericarditis is the swelling and inflammation of the pericardium. The pericardium is a thin membrane that anatomically surrounds the hearts, allows for flexibility of contraction and expansion during blood ejection as well as holding the heart in its anatomical position (Elias et al., 2017). There is a fluid called pericardial fluid that separates the pericardial membranes and prevents it from developing friction. Pericarditis is a common infection that is caused by bacteria, virus or fungi. People with a heart attack and those who have undergone any heart surgery are at risk of developing pericarditis. Besides, individuals on chest radiotherapy are at higher risk of developing pericarditis. Pericarditis can be categorized into two types that is early pericarditis and late pericarditis.
According to the provided case, the patient is suffering from heart disease. Besides the patient is from a bypass surgery, which places the patient at higher risk of developing pericarditis. The inflammation of the pericardial membrane could be due to the immune system response to the new procedure and condition of the heart (Elias et al., 2017). After bypass surgery, it can take more than four weeks for the patient to develop pericarditis.
Cardiac tamponade risk
The patient is at risk of developing cardiac tamponade because the inflammation of the pericardial membrane results in the build-up of excess pericardial fluid, which increases the pressure within the pericardium. The high pressure in the pericardium compresses the heart resulting in the development of cardiac tamponade. The pericardial fluid builds up between the heart and the pericardium, which exert unnecessary pressure on the heart muscle. Therefore reducing the functioning of the heart and can result in another heart failure, hypertension and kidney injury because the hearts’ ability to pump blood to the entire body organs is reduced. Cardiac tamponade acts as a clinical syndrome that causes lower ventricular filling and compromise in hemodynamics of the body. It is an emergency condition because it can lead to the development of shock, pulmonary edema and death.
Symptoms of cardiac tamponade
The symptoms of cardiac tamponade vary with the severity and the cause of the condition. Mainly, the patients with cardiac tamponade present with tachycardia, dyspnea and tachypnea and hypoperfusion, which results in cold extremities (Appleton, Gillam & Koulogiannis, 2017). Other symptoms of the condition include pulsus paradoxus, jugular venous pressure elevation, chest pressure, confusion, decreased urine output and dysphoria. The outer part of the heart is made of several fibrous tissues which rarely stretches, and the moment pericardial space is filled with pericardial fluid, the pressure begins to increase. The more the fluid accumulates; the blood entering the ventricles is reduced because of the limited diastolic period. The result is the increase in the pressure of the heart, which causes the septum to bend towards the left ventricle, which further leads to a reduced stroke volume. As such obstructive shock develops, that can result in cardiac arrest if not managed well.
Continuous fluid accumulation in the pericardial cavity results in an increase in pericardial pressure with respect to the ventricular filling pressure, which further results in reduced cardiac output. Diastolic refilling is diminished due to the inability of the transmural distending pressure to outgo the increasing intrapericardial pressures (Appleton, Gillam & Koulogiannis, 2017). As such, for the heart to respond to the changes, tachycardia occurs. The systemic venous return is greatly affected because of the pressure on the heart, and the pulmonary vascular bed is affected mainly resulting in the accumulation of blood at the venous circulation causing tachypnea and jugular vein distention.