What is pericarditis?
What is pericarditis?
The heart muscle has a tight covering that surrounds it, a lining sac called the pericardium (peri=around +cardium=heart). This sac actually has two layers. The visceral pericardium is only one cell layer thick and fits tightly onto the heart muscle. The parietal pericardium is much tougher and thicker and has fibers that tether the heart to the rib cage and diaphragm. There is a potential space between the layers, meaning that in normal situations, it has a minimal amount of fluid. However, should inflammation occur, it can fill with fluid. Inflammation of the lining of the heart is called pericarditis (itis=inflammation).
What are the symptoms for pericarditis?
Pericarditis has different classification types, depending on the pattern of symptoms and how long symptoms last. Acute pericarditis usually lasts less than three weeks. Incessant pericarditis lasts about four to six weeks but less than three months and is continuous.
Pericarditis is described as recurrent if it occurs about four to six weeks after an episode of acute pericarditis with a symptom-free interval in between. Pericarditis is considered chronic if symptoms last longer than three months.
If you have acute pericarditis, the most common symptom is sharp, stabbing Chest pain behind the breastbone or in the left side of your chest. However, some people with acute pericarditis describe their Chest pain as dull, achy or pressure-like instead, and of varying intensity.
The pain of acute pericarditis may travel into your left shoulder and neck. It often intensifies when you cough, lie down or inhale deeply. Sitting up and leaning forward can often ease the pain. At times, it may be difficult to distinguish pericardial pain from the pain that occurs with a heart attack.
Chronic pericarditis is usually associated with chronic inflammation and may result in fluid around the heart (pericardial effusion). The most common symptom of chronic pericarditis is Chest pain.
Depending on the type, signs and symptoms of pericarditis may include some or all of the following:
- Sharp, piercing Chest pain over the center or left side of the chest, which is generally more intense when breathing in
- Shortness of breath when reclining
- Heart Palpitations
- Low-grade Fever
- An overall sense of Weakness, Fatigue or feeling sick
- Abdominal or leg Swelling
When to see a doctor
Seek immediate medical care if you develop new symptoms of Chest pain.
Many of the symptoms of pericarditis are similar to those of other heart and lung conditions. The sooner you are evaluated, the sooner you can receive proper diagnosis and treatment. For example, although the cause of acute Chest pain may be pericarditis, the original cause could have been a heart attack or a blood clot of the lungs (pulmonary embolus).
What are the causes for pericarditis?
Under normal circumstances, the two-layered pericardial sac that surrounds your heart contains a small amount of lubricating fluid. In pericarditis, the sac becomes inflamed and the resulting friction from the inflamed sac leads to chest pain.
The cause of pericarditis is often hard to determine. In most cases, doctors either are unable to determine a cause (idiopathic) or suspect a viral infection.
Pericarditis can also develop shortly after a major heart attack, due to the irritation of the underlying damaged heart muscle. In addition, a delayed form of pericarditis may occur weeks after a heart attack or heart surgery.
This delayed pericarditis is known as Dressler's syndrome. Dressler's syndrome may also be called postpericardiotomy syndrome, post-myocardial infarction syndrome and post-cardiac injury syndrome.
Other causes of pericarditis include:
- Systemic inflammatory disorders. These may include lupus and rheumatoid arthritis.
- Trauma. Injury to your heart or chest may occur as a result of a motor vehicle or other accident.
- Other health disorders. These may include kidney failure, AIDS, tuberculosis and cancer.
- Certain medications. Some medications can cause pericarditis, although this is unusual.
What are the treatments for pericarditis?
Treatment for pericarditis depends on the cause and the severity of the symptoms. Mild pericarditis may get better without treatment.
Medications to reduce the inflammation and swelling are often prescribed. Examples include:
- Pain relievers. Pericarditis pain can usually be treated with over-the-counter pain relievers, such as aspirin or ibuprofen (Advil, Motrin IB, others). Prescription-strength pain relievers also may be used.
- Colchicine (Colcrys, Mitigare). This drug reduces inflammation in the body. It's used to treat acute pericarditis or if symptoms tend to come back. You should not take this drug if you have liver or kidney disease. Colchicine can also interfere with other drugs. Your health care provider will carefully check your health history before prescribing colchicine.
- Corticosteroids. Corticosteroids are strong medications that fight inflammation. A corticosteroid such as prednisone may be prescribed if pericarditis symptoms don't get better with other medications, or if symptoms keep returning.
If pericarditis is caused by a bacterial infection, treatment may include antibiotics and drainage, if necessary.
Surgeries or other procedures
If pericarditis causes fluid buildup around the heart, a surgery or other procedure may be needed to drain the fluid.
Surgeries or other procedures to treat pericarditis include:
- Pericardiocentesis. In this procedure, a sterile needle or a small tube (catheter) is used to remove and drain the excess fluid from the pericardial cavity.
- Removal of the pericardium (pericardiectomy). The entire pericardium may need to be removed if the sac surrounding the heart is permanently rigid due to constrictive pericarditis.
Is there a cure/medications for pericarditis?
There's no cure for pericarditis, but it can be treated.
The most effective treatment is to reduce the inflammation of the pericardium so that it can heal. This can be done through medication and/or physical therapy.
There are several medications that can be used to treat pericarditis. Some of these include:
- Prednisone: Prednisone is a steroid that reduces inflammation and pain in your body. It works by suppressing your immune system and decreasing inflammation in your body. It's best to take this medicine with food if you have stomach problems or nausea as a side effect of using prednisone may occur if it is taken on an empty stomach.
- Aspirin: Aspirin can be used to relieve pain caused by pericarditis, but it's important not to use aspirin if you have an allergy or sensitivity to aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs). If you have asthma, get medical advice before using aspirin because it may make asthma worse.
- Ibuprofen: Ibuprofen is another form of NSAID that can help reduce pain caused by pericarditis but should not be taken by people who have an allergy or sensitivity to ibuprofen.
Chest pain,Shortness of breath,Chills and fever,Fatigue,Swollen lymph nodes in the neck or armpits
Rheumatoid arthritis or systemic lupus erythematosus (SLE),Tuberculosis or fungal infections (histoplasmosis),Scleroderma or polymyositis/dermatomyositis,Cancers like lymphoma or leukemia,Physical injury such as a blunt trauma to your chest wall or post-traumatic stress disorder (PTSD)