All About Pericarditis

Pericarditis is an inflammation of the sac-like cover which surrounds the heart, called the pericardium. There are many possible causes for this condition, including fungal or bacterial infection, injury or trauma including that caused by surgery, side effects of medication, rheumatic fever, hypothyroidism, chest area radiation therapy, kidney failure or viral infection. Sometimes it is a complication of systemic disease such as lupus or cancer. Pericarditis can also result from myocarditis or heart attack.

Symptoms of pericarditis

Some symptoms of pericarditis may include, but are not limited to: difficulty breathing when the individual is lying down, fatigue, fever, a dry cough, and pain in the chest which increases upon coughing or swallowing and is often relieved when sitting up and leaning forward. The pain is caused by the pericardium rubbing up against the heart, and can be a dull ache or a sharp, stabbing pain. Sometimes there is swelling in the legs or abdomen.

If you are having these symptoms, seek medical attention immediately. This condition can be mild and easily treatable, but it can also be life-threatening. Some cases are acute and short-lived, but pericarditis can become a chronic condition, depending upon its cause.

Early treatment for pericarditis is crucial. If left untreated, the accumulated fluid around the heart can cause a condition called cardiac tamponade. This means there is too much pressure upon the heart, with less blood able to exit the heart. This results in lowering the individual's blood pressure to a dangerous, sometimes fatal, level.

If pericarditis is left untreated, constrictive pericarditis can also develop, a condition in which the pericardium becomes so scarred, thick, and rigid that the patient can not draw breath, and the abdomen and legs swell drastically.

Diagnosing pericarditis

Pericarditis can often be determined when the doctor listens to the patient's heart. There is usually a distinctive rubbing sound from the inflamed layers of the pericardium rubbing up against one another.

Other tests that may be done are an MRI, echocardiogram, electrocardiogram, computerized tomography, and a basic chest x-ray. There may be blood tests to determine if there is a bacterial infection present. Some of the tests will be to determine whether the patient has suffered a heart attack or whether there has been other damage to the heart. It's crucial to report all symptoms to the physician, along with making sure he has a complete medical history. The doctor needs this information to ensure that each individual is diagnosed and treated correctly.

Treatments and outlook for pericarditis

The pericarditis patient should get plenty of rest. If the condition involves bacterial infection, antibiotics will be given. Other possible medicines can include colchicine to reduce inflammation, non-steroidal anti-inflammatory drugs such as aspirin, or stronger narcotic pain relievers if needed for a brief period. Colchicine will be avoided for some individuals with some pre-existing health problems involving the liver or kidneys. Corticosteroids such as prednisone may be given to patients with chronic pericarditis which is nonresponsive to other medications.

If the heart is dangerously restricted, as in cardiac tamponade, surgical procedures may be necessary. Drainage of the fluid around the heart might need to be done. This procedure is called pericardiocentesis. A catheter or sterile needle is employed to drain excess fluid from the pericardium. The patient may remain hospitalized for several days during this procedure while the drainage process continues.

In extreme cases, surgery may be done to remove the entire pericardium. This is only done in drastic life-threatening cases where the pericardial sac has become so rigid it continues to dangerously constrict heart function.

The outlook for patients with pericarditis is usually good provided the individual seeks early treatment. Some cases caused by respiratory illness are mild and resolve themselves with little medication.

Sources:

Signet/Mosby Medical Encyclopedia
Mayo Clinic
National Institute of Health